Research Team for Promoting Independence of Elderly, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
Arch Gerontol Geriatr. 2013 Nov-Dec;57(3):352-9. doi: 10.1016/j.archger.2013.06.008. Epub 2013 Jul 11.
Knee pain is a common health problem in the elderly population, for which non-invasive treatments are recommended as a first line treatment in the management of knee pain. A randomized controlled trial was conducted to determine the effects of exercise with or without thermal therapy in community-dwelling elderly women with chronic knee pain. Women over 75 years of age with knee pain (n=150) were randomly assigned into four groups; exercise (Ex) and heat/steam generating sheet (HSGS) (n=38), Ex (n=37), HSGS (n=38), or health education (HE) (n=37). The Ex group attended a 60-min comprehensive training program twice a week for 3-months. The HSGS group placed two sheets on the knee for five hours per day. Functional fitness, visual analog scale (VAS), and Japanese knee osteoarthritis measure (JKOM) were assessed at baseline and post-intervention. The results showed VAS improvements in the Ex+HSGS and HSGS groups. Total JKOM score, muscle strength, and functional mobility significantly improved in the Ex+HSGS group compared with the HE group. The odds ratio (OR) for VAS and functional mobility improvement was more than eight times as great in the Ex+HSGS group (OR=8.60, 95% confidence interval (CI)=2.82-32.73) compared with the education group. Ex or HSGS alone were insufficient in enhancing functional fitness or improving pain and quality of life. The combined effects of both Ex and heat therapy seems to have an added benefit of decreasing pain, improving physical function and increasing quality of life.
JMA-IIA00110.
背景:膝关节疼痛是老年人常见的健康问题,建议对其进行非侵入性治疗作为膝关节疼痛管理的一线治疗。本研究旨在评估运动联合或不联合热疗对社区居住的老年膝关节疼痛女性的影响。
方法:本研究纳入了 150 例 75 岁以上膝关节疼痛的女性患者,随机分为 4 组,分别为运动+热疗组(Ex+HSGS)、运动组(Ex)、热疗组(HSGS)和健康教育组(HE)。Ex 组每周接受 2 次,每次 60 分钟的综合训练方案;HSGS 组每天在膝关节上放置 2 片热疗片,每次 5 小时。分别于基线和干预后评估功能性体能、视觉模拟量表(VAS)和日本膝关节骨关节炎评估量表(JKOM)。
结果:与 HE 组相比,Ex+HSGS 组和 HSGS 组的 VAS 评分均有改善。与 HE 组相比,Ex+HSGS 组的 JKOM 总分、肌肉力量和功能性移动能力显著改善。与健康教育组相比,Ex+HSGS 组 VAS 和功能性移动能力改善的优势比(OR)超过 8 倍(OR=8.60,95%置信区间(CI)=2.82-32.73)。单独运动或热疗不足以增强功能性体能或改善疼痛和生活质量。运动联合热疗的联合作用似乎具有减轻疼痛、改善身体功能和提高生活质量的额外益处。
结论:本研究结果表明,运动联合热疗可能是一种有效的治疗方案,可改善老年膝关节疼痛女性的疼痛、身体功能和生活质量。
临床试验注册号:JMA-IIA00110。