Shinoro Orthopedic Hospital, Sapporo, Hokkaido, Japan.
Physiother Theory Pract. 2013 Feb;29(2):87-95. doi: 10.3109/09593985.2012.702854. Epub 2012 Jul 30.
Manual therapy has proven to be a benefit in the management of knee osteoarthritis (OA), but the effects of the method of Mulligan's mobilization with movement (MWM) have yet to be explored in knee OA. As a first step, this case series investigated MWM's immediate and short-term benefits over three occasions of treatment in 19 patients with knee OA. Patients (71.1 ± SD 13.9 years, 14 females and 5 males) received individually prescribed MWM and performed self-MWM. Outcome measures included: 1) pain intensity (visual analog scales) during walking, ascending and descending stairs, and sit-to-stand; 2) passive flexion and extension range of motion (ROM); and 3) Activities of Daily Living Scale of the Knee Outcome Survey (KOS-ADLS). Pain and ROM were assessed at baseline, after the initial treatment, before the second treatment and at exit following the fourth consultation. The KOS-ADLS was assessed at baseline and at exit. Significant improvements from baseline were detected in flexion ROM and pain scores in all tasks following the initial treatment (P < 0.05/3). The KOS-ADLS score improved significantly from baseline (67.1% ± SD 16.6%) to exit (86.3% ± SD 12.6%) (P < 0.001). MWM was associated with immediate pain relief and improved knee function, suggesting its potential as a component of early management of knee OA.
手法治疗已被证明对膝骨关节炎(OA)的管理有益,但 Mulligan 运动性关节松动术(MWM)的方法对膝 OA 的影响仍有待探索。作为第一步,本病例系列研究了 19 例膝骨关节炎患者在三次治疗中 MWM 的即时和短期益处。患者(71.1 ± 13.9 岁,女性 14 例,男性 5 例)接受个体化 MWM 治疗,并进行自我 MWM。结果测量包括:1)行走、上下楼梯和坐站时的疼痛强度(视觉模拟量表);2)被动屈伸活动度(ROM);3)膝关节结局调查的日常生活活动量表(KOS-ADLS)。在基线、初始治疗后、第二次治疗前和第四次就诊结束时评估疼痛和 ROM。在基线和就诊结束时评估 KOS-ADLS。初始治疗后所有任务的 ROM 和疼痛评分均较基线显著改善(P < 0.05/3)。KOS-ADLS 评分从基线(67.1% ± 16.6%)显著改善至就诊结束(86.3% ± 12.6%)(P < 0.001)。MWM 与即时缓解疼痛和改善膝关节功能相关,提示其有作为膝骨关节炎早期管理的一个组成部分的潜力。