Elbadawy Mohja A
Ain Shams University Faculty of Medicine, Cairo, Egypt.
Clin J Pain. 2017 Mar;33(3):254-263. doi: 10.1097/AJP.0000000000000404.
Osteoarthritis (OA) of the knee is the most common form of joint disease. It is one of the major causes of impaired function that reduces quality of life in older people worldwide. Periosteal Stimulation Therapy (PST) with boosters in combination with home exercises may be a suitable treatment option for such patients.
To examine the effectiveness of PST with boosters in addition to a home-based exercise program as compared with Transcutaneous Electrical Nerve Stimulation (TENS) combined with the same home-based exercise program in the management of chronic pain and functional impairments associated with advanced knee OA.
The study was a randomized controlled trial.
Sixty patients with Kellgren-Lawrence grade 3 or 4 knee OA were randomized to receive PST or TENS once a week for 10 weeks, followed by boosters for 6 months in addition to a home exercise program. Visual Analogue Scale (VAS) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales were assessed at baseline, after the last PST session, and 6 months later.
Pain VAS and KOOS subscales were improved in both PST and TENS groups at 10 weeks and 6 months after intervention, with a statistically significant difference between the groups at both follow-up periods. Reduced pain VAS and increased KOOS subscales in the PST group were statistically significantly different from the TENS group during both follow-up periods.
PST with boosters combined with a home exercise program was shown to be beneficial for improving subjective knee pain and functional performance of older patients with advanced knee OA.
膝关节骨关节炎(OA)是最常见的关节疾病形式。它是导致功能受损的主要原因之一,降低了全球老年人的生活质量。骨膜刺激疗法(PST)结合强化治疗以及家庭锻炼可能是这类患者合适的治疗选择。
研究与经皮电刺激神经疗法(TENS)结合相同的家庭锻炼计划相比,PST结合强化治疗以及家庭锻炼计划在管理与晚期膝关节OA相关的慢性疼痛和功能障碍方面的有效性。
该研究为随机对照试验。
60例Kellgren-Lawrence 3级或4级膝关节OA患者被随机分组,每周接受一次PST或TENS治疗,共10周,之后除家庭锻炼计划外,还接受6个月的强化治疗。在基线、最后一次PST治疗后以及6个月后评估视觉模拟量表(VAS)和膝关节损伤与骨关节炎疗效评分(KOOS)子量表。
干预后10周和6个月时,PST组和TENS组的疼痛VAS和KOOS子量表均有所改善,在两个随访期两组之间均有统计学显著差异。在两个随访期内,PST组疼痛VAS降低和KOOS子量表升高与TENS组相比均有统计学显著差异。
PST结合强化治疗以及家庭锻炼计划被证明有利于改善晚期膝关节OA老年患者的主观膝关节疼痛和功能表现。