Department of Nursing, National Taipei College of Nursing, Taipei, Taiwan.
J Clin Nurs. 2011 Sep;20(17-18):2609-22. doi: 10.1111/j.1365-2702.2010.03675.x. Epub 2011 May 4.
The study aims to compare changes over time among three study groups on the primary outcome, pain, as well as on the secondary outcomes, other symptoms, activities of daily living function, sport and recreation function, knee-related quality of life, knee range of motions and the six-minute walk test and to investigate whether aquatic exercises would be superior compared with land exercise on pain reduction.
Osteoarthritis is a prevalent musculoskeletal disorder. Appropriate exercise may prevent osteoarthritis-associated disabilities and increase life quality. To date, research that compares the effects of different types of exercise for knee osteoarthritis has been limited.
The study is a randomised trial.
Eighty-four participants with knee osteoarthritis were recruited from local community centres. Participants were randomly assigned to the control, aquatic or land-based exercise group. Exercise in both groups ran for 60 minutes, three times a week for 12 weeks. Data were collected at baseline, week 6 and week 12 during 2006-2007. The instruments included the Knee Injury and Osteoarthritis Outcome Score, a standard plastic goniometer and the six-minute walk test. Generalised estimation equations were used to compare changes over time among groups for key outcomes.
Results showed statistically significant group-by-time interactions in pain, symptoms, sport/recreation and knee-related quality of life dimensions of Knee Injury and Osteoarthritis Outcome Score, knee range of motions and the six-minute walk test. However, the aquatic group did not show any significant difference from the land group at both weeks 12 and 6.
Both aquatic and land-based exercise programmes are effective in reducing pain, improving knee range of motions, six-minute walk test and knee-related quality of life in people with knee osteoarthritis. The aquatic exercise is not superior to land-based exercise in pain reduction.
Similar outcomes could be possible with the two programmes. Health care professionals may consider suggesting well-designed aquatic or land-based exercise classes for patients with osteoarthritis, based on their preferences and convenience.
本研究旨在比较三组患者在主要结局（疼痛）和次要结局（其他症状、日常生活活动功能、运动/娱乐功能、膝关节相关生活质量、膝关节活动度和 6 分钟步行测试）上的随时间变化，并探讨水中运动在减轻疼痛方面是否优于陆地运动。
骨关节炎是一种常见的肌肉骨骼疾病。适当的运动可以预防骨关节炎相关的残疾，提高生活质量。迄今为止，比较不同类型运动对膝骨关节炎影响的研究有限。
本研究为随机试验。
从当地社区中心招募了 84 名膝骨关节炎患者。患者被随机分配到对照组、水中运动组或陆地运动组。两组的运动均为 60 分钟，每周 3 次，持续 12 周。2006-2007 年期间收集基线、第 6 周和第 12 周的数据。评估工具包括膝关节损伤和骨关节炎结果评分（Knee Injury and Osteoarthritis Outcome Score，KOOS）、标准塑料量角器和 6 分钟步行测试。使用广义估计方程比较各组主要结局的随时间变化。
结果显示，在 KOOS 的疼痛、症状、运动/娱乐和膝关节相关生活质量维度、膝关节活动度和 6 分钟步行测试方面，组间存在统计学显著的时间交互作用。然而，在第 12 周和第 6 周时，水中运动组与陆地运动组之间均无显著差异。
水中运动和陆地运动方案均能有效减轻膝骨关节炎患者的疼痛，改善膝关节活动度、6 分钟步行测试和膝关节相关生活质量。在减轻疼痛方面，水中运动并不优于陆地运动。
两种方案可能会产生相似的效果。健康护理专业人员可以根据患者的偏好和方便程度，建议他们参加精心设计的水中或陆地运动课程。
