Gelenkpunkt - Sport and Joint Surgery, Olympiastraße 39, 6020, Innsbruck, Austria.
Research Unit of Orthopedic Sports Medicine and Injury Prevention, Institute for Sports Medicine, Alpine Medicine and Health Tourism (ISAG), UMIT, Eduard-Wallnöfer-Zentrum 1, 6060, Hall in Tirol, Austria.
Knee Surg Sports Traumatol Arthrosc. 2017 Nov;25(11):3387-3395. doi: 10.1007/s00167-016-4299-3. Epub 2016 Sep 1.
Improvements in pain, function and sports activity are the main goals of patients following total knee arthroplasty (TKA). Participation in sports has become an increasingly important contributor to patients' quality of life (QoL). Hiking is one of the most popular summer activities among elderly people in alpine regions. Consequently, this randomized controlled trial investigates the impact of a 3-month guided hiking programme on patients' functional abilities and QoL following TKA. It was hypothesized that patients who participate in this programme would demonstrate improvements in functional and QoL parameters compared with a control group.
Forty-eight TKA patients were included and randomized into either the intervention group (IG; n = 25) or the control group (CG; n = 23). The IG participated in a 3-month hiking programme (2-3 times a week), whereas the CG performed activities of daily living. The stair climb test (SCT), QoL questionnaires and isokinetic force measurements were completed at three time points (i.e. pre-test, post-test, retention-test). ANOVAs for repeated measurements were conducted for the SCT results. The Friedman test and the Mann-Whitney U test were performed for the QoL parameters.
After the 3-month hiking programme, the IG achieved faster overall walking times on the SCT. The time decreased from 4.3 ± 0.6 s (pre-test) to 3.6 ± 0.4 s (post-test) for the stair ascent (p = 0.060) and from 3.6 ± 0.6 s (pre-test) to 3.2 ± 0.5 s (post-test) for the stair descent (p = 0.036). The IG showed significant improvement on some of the subscales of the Knee Injury and Osteoarthritis Outcome Score from pre-test to retention-test (p < 0.01). In the CG, no significant changes were observed (n.s.).
The results indicate moderate improvement in the functional abilities and QoL of TKA patients who participated in a 3-month guided hiking programme compared with the patients in the CG. Hiking did not have any acute detrimental effects on the TKA patients during this study period.
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改善疼痛、功能和体育活动是全膝关节置换术（TKA）后患者的主要目标。参与运动已成为患者生活质量（QoL）的一个越来越重要的贡献因素。徒步旅行是阿尔卑斯地区老年人夏季最受欢迎的活动之一。因此，这项随机对照试验调查了为期 3 个月的指导徒步旅行计划对 TKA 后患者功能能力和生活质量的影响。假设是，与对照组相比，参加该计划的患者在功能和 QoL 参数方面将有所改善。
共纳入 48 例 TKA 患者，并随机分为干预组（IG；n=25）和对照组（CG；n=23）。IG 参加了为期 3 个月的徒步旅行计划（每周 2-3 次），而 CG 则进行日常生活活动。在三个时间点（即预测试、后测试、保留测试）完成了楼梯攀爬测试（SCT）、生活质量问卷和等速肌力测量。对 SCT 结果进行重复测量方差分析。对 QoL 参数进行 Friedman 检验和 Mann-Whitney U 检验。
在为期 3 个月的徒步旅行计划后，IG 在 SCT 上的整体行走时间更快。楼梯上升的时间从 4.3±0.6 s（预测试）减少到 3.6±0.4 s（后测试）（p=0.060），楼梯下降的时间从 3.6±0.6 s（预测试）减少到 3.2±0.5 s（后测试）（p=0.036）。IG 在从预测试到保留测试的 Knee Injury and Osteoarthritis Outcome Score 的一些子量表上显示出显著改善（p<0.01）。CG 中未观察到显著变化（n.s.）。
结果表明，与 CG 相比，参加为期 3 个月的指导徒步旅行计划的 TKA 患者的功能能力和生活质量有中等程度的改善。在本研究期间，徒步旅行对 TKA 患者没有任何急性不利影响。
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