Al-Khlaifat Lara, Herrington Lee C, Hammond Alison, Tyson Sarah F, Jones Richard K
School of Health Sciences, University of Salford, Salford M66PU, United Kingdom; Faculty of Rehabilitation Sciences, The University of Jordan, 11942 Amman, Jordan.
School of Health Sciences, University of Salford, Salford M66PU, United Kingdom.
Knee. 2016 Jan;23(1):63-9. doi: 10.1016/j.knee.2015.03.014. Epub 2015 May 4.
Osteoarthritis (OA), which increases knee loading, muscle co-contraction, and pain, is a mechanical disease that requires biomechanical exploration to reduce pain in the knee. Therefore, this article aims to investigate the effectiveness of an exercise programme on the aforementioned outcomes in people with medial knee OA.
Cohort pilot study design. A total of 19 patients with knee OA attended a six-week group exercise programme integrated with self-management education. The following outcomes were assessed before and after the exercise programme: external knee adduction moment (EKAM), knee adduction angular impulse (KAAI), knee antagonist muscle co-contraction, and pain subscale of the knee injury and osteoarthritis outcome score (KOOS).
Of the 19 patients, 14 completed the study. The EKAM and KAAI did not show statistical significance post-exercise intervention (p=0.21-0.7 and 0.56, respectively). Muscle co-contraction between vastus lateralis and biceps femoris muscles decreased in early-stance (64.78 (44.35) compared with 38.10 (23.10), p=0.01) and mid-stance (27.62 (32.12) compared with 14.94 (17.40), p=0.04). A corresponding significant pain reduction was observed (p=0.00) with a median (range) of 51.50 (47.00 to 62.50) at week 6 compared with 34.50 (29.25 to 41.25) at baseline.
This is the first known study to explore the effect of an exercise programme on knee loading and muscle co-contraction in patients with OA. Although the value of EKAM did not change, the findings suggest that the reduction in vastus lateralis and biceps femoris co-contraction might be the mechanism behind the reduction of pain.
骨关节炎（OA）会增加膝关节负荷、肌肉协同收缩并引发疼痛，这是一种需要进行生物力学探究以减轻膝关节疼痛的机械性疾病。因此，本文旨在研究一项运动计划对内侧膝关节OA患者上述各项指标的有效性。
队列试点研究设计。共有19名膝关节OA患者参加了一项为期六周的团体运动计划，并结合自我管理教育。在运动计划前后评估以下指标：膝关节外展力矩（EKAM）、膝关节内收角冲量（KAAI）、膝关节拮抗肌协同收缩以及膝关节损伤和骨关节炎疗效评分（KOOS）的疼痛子量表。
19名患者中，14名完成了研究。运动干预后，EKAM和KAAI未显示出统计学意义（p分别为0.21 - 0.7和0.56）。股外侧肌和股二头肌之间的肌肉协同收缩在早期站立时有所下降（从64.78（44.35）降至38.10（23.10），p = 0.01），在中期站立时也有所下降（从27.62（32.12）降至14.94（17.40），p = 0.04）。观察到疼痛相应显著减轻（p = 0.00），第6周时中位数（范围）为51.50（47.00至62.50），而基线时为34.50（29.25至41.25）。
这是已知的第一项探索运动计划对OA患者膝关节负荷和肌肉协同收缩影响的研究。尽管EKAM的值没有变化，但研究结果表明股外侧肌和股二头肌协同收缩的减少可能是疼痛减轻的背后机制。
