Department of Physical Medicine and Rehabilitation, Gulhane Military Medical Academy, 06018 Etlik-Ankara, Turkey.
Rheumatol Int. 2012 Dec;32(12):3793-8. doi: 10.1007/s00296-011-2272-5. Epub 2011 Dec 21.
Impaired proprioceptive perception and the balance function are known to associate with knee osteoarthritis. The previous publications have reported the beneficial effects of proprioceptive exercises on mild or moderate knee osteoarthritis. Scientific data in the literature regarding their effects in advanced stages of knee osteoarthritis are lacking. The objective of this study is to investigate the impact of the proprioceptive exercises on balance, proprioceptive perception and clinical findings in advanced-stage knee osteoarthritis. Fifty-four patients diagnosed as having knee osteoarthritis according to the American Collage of Rheumatology criteria with grade of 3 or higher according to the Kellgren-Lawrence scale were enrolled in the study. Patients were allocated randomly into two groups. The study group included 30 patients, and the control group included 24 patients. The proprioceptive perception was assessed by the ability to reproduce the knee position. The balance function was assessed by stabilometric evaluation in static and dynamic patterns. The clinical evaluation was made by using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Patients were reevaluated after the three-week proprioceptive rehabilitation program. The improvement in the scores of static balance was significant statistically. No significant improvement in the dynamic balance scores was obtained. Although the measurements of proprioceptive perception showed a tendency toward improvement, the difference was not significant statistically. The WOMAC scores showed better improvements in the study group. As conclusion, in further stages of knee osteoarthritis, proprioceptive exercises have beneficial effects on static balance and to some extent on proprioceptive accuracy. In the treatment for advanced knee osteoarthritis, adding exercises specifically targeting the proprioceptive and balance dysfunction might be useful.
本体感觉感知受损和平衡功能障碍与膝骨关节炎有关。先前的出版物已经报道了本体感觉练习对轻度或中度膝骨关节炎的有益效果。关于其在膝骨关节炎晚期的影响的文献中的科学数据缺乏。本研究的目的是调查本体感觉练习对晚期膝骨关节炎的平衡、本体感觉感知和临床发现的影响。根据美国风湿病学会的标准诊断为膝骨关节炎的 54 例患者，根据 Kellgren-Lawrence 量表，其等级为 3 或更高，被纳入本研究。患者被随机分为两组。研究组包括 30 例患者，对照组包括 24 例患者。本体感觉感知通过复制膝关节位置的能力来评估。平衡功能通过静态和动态模式的平衡评估来评估。临床评估采用 Western Ontario 和 McMaster 大学骨关节炎指数（WOMAC）进行。患者在进行为期三周的本体感觉康复计划后进行重新评估。静态平衡的评分改善具有统计学意义。动态平衡评分没有显著改善。尽管本体感觉感知的测量值显示出改善的趋势，但差异没有统计学意义。研究组的 WOMAC 评分有更好的改善。总之，在膝骨关节炎的进一步阶段，本体感觉练习对静态平衡有有益的影响，在某种程度上对本体感觉准确性也有有益的影响。在晚期膝骨关节炎的治疗中，增加专门针对本体感觉和平衡功能障碍的练习可能是有用的。
