关节炎软骨健康的抗阻运动（REACH）：一项随机双盲、假运动对照试验。
Resistive Exercise for Arthritic Cartilage Health (REACH): a randomized double-blind, sham-exercise controlled trial.
作者信息
Lange Angela K, Vanwanseele Benedicte, Foroughi Nasim, Baker Michael K, Shnier Ronald, Smith Richard M, Singh Maria A Fiatarone
机构信息
Exercise, Health and Performance Faculty Research Group, Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia.
出版信息
BMC Geriatr. 2009 Jan 13;9:1. doi: 10.1186/1471-2318-9-1.
BACKGROUND
This article provides the rationale and methodology, of the first randomised controlled trial to our knowledge designed to assess the efficacy of progressive resistance training on cartilage morphology in women with knee osteoarthritis.Development and progression of osteoarthritis is multifactorial, with obesity, quadriceps weakness, joint malalignment, and abnormal mechanical joint forces particularly relevant to this study. Progressive resistance training has been reported to improve pain and disability in osteoarthritic cohorts. However, the disease-modifying potential of progressive resistance training for the articular cartilage degeneration characteristic of osteoarthritis is unknown. Our aim was to investigate the effect of high intensity progressive resistance training on articular cartilage degeneration in women with knee osteoarthritis.
METHODS
Our cohort consisted of women over 40 years of age with primary knee osteoarthritis, according to the American College of Rheumatology clinical criteria. Primary outcome was blinded measurement of cartilage morphology via magnetic resonance imaging scan of the tibiofemoral joint. Secondary outcomes included walking endurance, balance, muscle strength, endurance, power, and velocity, body composition, pain, disability, depressive symptoms, and quality of life.Participants were randomized into a supervised progressive resistance training or sham-exercise group. The progressive resistance training group trained muscles around the hip and knee at 80% of their peak strength and progressed 3% per session, 3 days per week for 6 months. The sham-exercise group completed all exercises except hip adduction, but without added resistance or progression. Outcomes were repeated at 3 and 6 months, except for the magnetic resonance imaging scan, which was only repeated at 6 months.
DISCUSSION
Our results will provide an evaluation of the disease-modifying potential of progressive resistance training for osteoarthritis.
TRIAL REGISTRATION
ANZCTR Reference No. 12605000116628.
背景
据我们所知，本文提供了首个旨在评估渐进性抗阻训练对膝关节骨关节炎女性软骨形态疗效的随机对照试验的基本原理和方法。骨关节炎的发生和发展是多因素的，肥胖、股四头肌无力、关节排列不齐以及异常的关节机械力与本研究尤为相关。据报道，渐进性抗阻训练可改善骨关节炎患者的疼痛和功能障碍。然而，渐进性抗阻训练对骨关节炎特征性的关节软骨退变的疾病修饰潜力尚不清楚。我们的目的是研究高强度渐进性抗阻训练对膝关节骨关节炎女性关节软骨退变的影响。
方法
我们的队列由根据美国风湿病学会临床标准诊断为原发性膝关节骨关节炎的40岁以上女性组成。主要结局是通过胫股关节磁共振成像扫描对软骨形态进行盲法测量。次要结局包括步行耐力、平衡、肌肉力量、耐力、功率和速度、身体成分、疼痛、功能障碍、抑郁症状和生活质量。参与者被随机分为监督下的渐进性抗阻训练组或假运动组。渐进性抗阻训练组以其峰值力量的80%训练髋部和膝部周围的肌肉，每次训练增加3%，每周训练3天，共6个月。假运动组完成除髋内收以外的所有运动，但不增加阻力或强度。除磁共振成像扫描仅在6个月时重复外，其他结局在3个月和6个月时重复测量。
讨论
我们的结果将对渐进性抗阻训练对骨关节炎的疾病修饰潜力进行评估。
试验注册
澳大利亚和新西兰临床试验注册中心编号：12605000116628。
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