治疗超声治疗膝骨关节炎的疗效：一项随机、对照、双盲研究。

Efficacy of therapeutic ultrasound for the management of knee osteoarthritis: a randomized, controlled, and double-blind study.

机构信息

From the Department of Physical Medicine and Rehabilitation, Medical Faculty of Ege University, Izmir, Turkey.

出版信息

Am J Phys Med Rehabil. 2014 May;93(5):405-12. doi: 10.1097/PHM.0000000000000033.

DOI:10.1097/PHM.0000000000000033

PMID:24322433

Abstract

OBJECTIVE

The aim of this study was to compare whether the effectiveness of continuous ultrasound (US) was superior against pulsed US and against sham US in knee osteoarthritis.

DESIGN

A randomized controlled study was carried out on 60 patients diagnosed with knee osteoarthritis according to American College of Rheumatology. The patients were randomized into the following three treatments: (1) continuous US (at a frequency of 1 MHz with intensity of 1 W/cm), (2) pulse US (same frequency and intensity on 1:4 pulse ratio), and (3) sham US. All treatments were applied with 5-cm head US device five times a week for 2 weeks in addition to home exercise program including quadriceps isometric exercise, muscle strength exercises, and stretching exercises of the lower extremity muscles for at least three times per week. Assessments were performed at baseline, at the end of the treatment, and at the end of the treatments and at the sixth month using the following measurements: Western Ontario and McMaster University Osteoarthritis Index-pain, stiffness, function, visual analog scale-pain at rest, visual analog scale-pain on movement, visual analog scale-disease severity, and 20-m walking time. Among these parameters, the Western Ontario and McMaster University Osteoarthritis Index-pain was the primary outcome.

RESULTS

All groups showed a significant improvement in all parameters in both following visits (P < 0.05). However, there was no significant difference between the groups. Although the mean reduction percent in Western Ontario and McMaster University Osteoarthritis Index-pain was significantly higher in group I (continuous US) when compared to sham group (46.5% vs 28.9%, P < 0.05) at the end of the treatment, this result was not found in other pain parameters.

CONCLUSIONS

The present study demonstrated that all assessment parameters significantly improved in all groups without a significant difference. This result suggested that therapeutic US provided no additional benefit in improving pain and functions in addition to exercise training.

摘要

目的

本研究旨在比较连续超声（US）与脉冲超声和假超声相比，在膝骨关节炎中的疗效。

设计

对 60 例根据美国风湿病学会诊断为膝骨关节炎的患者进行了一项随机对照研究。患者随机分为以下三种治疗组：（1）连续 US（频率为 1 MHz，强度为 1 W/cm），（2）脉冲 US（相同频率和强度，脉冲比为 1:4），和（3）假 US。所有治疗均采用 5cm 头式 US 仪，每周 5 次，共 2 周，同时还进行家庭运动方案，包括股四头肌等长运动、肌肉力量运动和下肢肌肉伸展运动，每周至少 3 次。在基线、治疗结束时、治疗结束后和第 6 个月进行评估，使用以下测量指标：西部安大略省和麦克马斯特大学骨关节炎指数-疼痛、僵硬、功能、视觉模拟量表-休息时疼痛、视觉模拟量表-运动时疼痛、视觉模拟量表-疾病严重程度和 20 米行走时间。在这些参数中，西部安大略省和麦克马斯特大学骨关节炎指数-疼痛是主要结局。