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不同阶段膝关节骨关节炎患者的性别差异。

Sex differences in patients with different stages of knee osteoarthritis.

作者信息

Logerstedt David S, Zeni Joseph, Snyder-Mackler Lynn

机构信息

Department of Physical Therapy, University of Delaware, Newark, DE.

Department of Physical Therapy, University of Delaware, Newark, DE.

出版信息

Arch Phys Med Rehabil. 2014 Dec;95(12):2376-81. doi: 10.1016/j.apmr.2014.07.414. Epub 2014 Aug 22.

DOI:10.1016/j.apmr.2014.07.414
PMID:25152171
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4254053/
Abstract

OBJECTIVE

To quantify the differences in physical impairments and in performance-based measures and patient-reported outcomes in men and women seeking nonoperative management of symptomatic moderate knee osteoarthritis (OA) and those with symptomatic end-stage knee OA scheduled for total knee arthroplasty compared with healthy controls.

DESIGN

Cross-sectional analysis of individuals referred to physical therapy, community participants, and subjects from a 2-year longitudinal study.

SETTING

University research department.

PARTICIPANTS

Cross-sectional analysis of participants (N=289) consisting of a moderate OA group (n=83), a severe OA group (n=143), and a healthy control group (n=63).

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Quadriceps strength, timed Up and Go test, stair-climbing test, 6-minute walk test, Knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS), and Physical Component Summary (PCS) of the Medical Outcomes Study 36-Item Short-Form Health Survey.

RESULTS

Women had worse scores than men for physical impairment and performance-based measures (P<.001). In the moderate OA group, women had significantly lower KOS-ADLS (P=.007) and PCS (P=.026) scores than men, with no differences seen between sexes in the other 2 groups for patient-reported measures.

CONCLUSIONS

Differences between women and men with knee OA on physical impairments and performance-based measures are not echoed in the differences seen in patient-reported measures. These measures signal different domains of knee function in patients with knee OA and should be used as part of a comprehensive functional evaluation.

摘要

目的

量化寻求非手术治疗的有症状的中度膝骨关节炎(OA)患者以及计划进行全膝关节置换术的有症状终末期膝OA患者与健康对照相比,在身体损伤、基于表现的测量指标以及患者报告结局方面的差异。

设计

对转介至物理治疗的个体、社区参与者以及来自一项为期2年的纵向研究的受试者进行横断面分析。

设置

大学研究部门。

参与者

对参与者(N = 289)进行横断面分析,包括中度OA组(n = 83)、重度OA组(n = 143)和健康对照组(n = 63)。

干预措施

不适用。

主要结局指标

股四头肌力量、定时起立行走测试、爬楼梯测试、6分钟步行测试、膝关节结局调查-日常生活活动量表(KOS-ADLS)以及医学结局研究36项简短健康调查的身体成分总结(PCS)。

结果

在身体损伤和基于表现的测量指标方面,女性得分比男性差(P <.001)。在中度OA组中,女性的KOS-ADLS(P =.007)和PCS(P =.026)得分显著低于男性,在其他两组的患者报告测量指标中未观察到性别差异。

结论

膝OA患者中女性和男性在身体损伤和基于表现的测量指标上的差异,在患者报告的测量指标差异中未得到体现。这些测量指标反映了膝OA患者膝关节功能的不同领域,应作为综合功能评估的一部分使用。

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本文引用的文献

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Muscle strength is the main associated factor of physical performance in older adults with knee osteoarthritis regardless of radiographic severity.肌肉力量是膝关节骨关节炎老年患者身体机能的主要相关因素,与影像学严重程度无关。
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Improved function from progressive strengthening interventions after total knee arthroplasty: a randomized clinical trial with an imbedded prospective cohort.全膝关节置换术后渐进性强化干预改善功能:一项嵌入前瞻性队列的随机临床试验
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Cross-cultural adaptation and validation of the Portuguese version of the Knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS).《膝关节功能评定量表-日常生活活动能力量表》(KOS-ADLS)葡萄牙语版本的跨文化调适与验证
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