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运动可改变膝骨关节炎患者的步态模式,但不会改变其膝关节负荷。

Exercise Alters Gait Pattern but Not Knee Load in Patients with Knee Osteoarthritis.

作者信息

Chang Ssu-Yu, Lin Yi-Jia, Hsu Wei-Chun, Hsieh Lin-Fen, Lin Yuan-Hsiang, Chang Chao-Chin, Chou You-Cai, Chen Li-Fei

机构信息

Department of Physical Medicine and Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 111, Taiwan.

Graduate Institute of Biomedical Engineering, National Taiwan University of Science and Technology, Taipei 106, Taiwan.

出版信息

Biomed Res Int. 2016;2016:7468937. doi: 10.1155/2016/7468937. Epub 2016 Sep 20.

Abstract

Six female patients with bilateral medial knee OA and 6 healthy controls were recruited. Patients with knee OA received a 6-week physiotherapist-supervised and home-based exercise program. Outcome measures, including the Western Ontario and McMaster Universities Arthritis Index and Short Form-36 Health Survey as well as objective biomechanical indices were obtained at baseline and follow-up. After treatment, no significant difference was observed in the knee abductor moment (KAM), lever arm, and ground reaction force. We, however, observed significantly improved pain and physical function as well as altered gait patterns, including a higher hip flexor moment and hip extension angle with a faster walking speed. Although KAM was unchanged, patients with bilateral knee OA showed an improved walking speed and altered the gait pattern after 6 weeks of supervised exercise. This finding suggests that the exercise intervention improves proximal joint mechanics during walking and can be considered for patients with bilateral knee OA. Non-weight-bearing strengthening without external resistance combined with stretching exercise may be an option to improve pain and function in individuals with OA who cannot perform high resistance exercises owing to pain or other reasons.

摘要

招募了6名双侧膝关节内侧骨关节炎女性患者和6名健康对照者。膝关节骨关节炎患者接受了为期6周的由物理治疗师指导的居家锻炼计划。在基线和随访时获取了包括西安大略和麦克马斯特大学骨关节炎指数、简短健康调查问卷36项以及客观生物力学指标在内的结果测量值。治疗后,在膝关节外展力矩(KAM)、力臂和地面反作用力方面未观察到显著差异。然而,我们观察到疼痛和身体功能有显著改善,步态模式也有所改变,包括髋部屈肌力矩增加、髋部伸展角度增大以及步行速度加快。尽管KAM没有变化,但双侧膝关节骨关节炎患者在接受6周的监督锻炼后,步行速度有所提高,步态模式也发生了改变。这一发现表明,运动干预可改善步行过程中近端关节力学,双侧膝关节骨关节炎患者可考虑采用。对于因疼痛或其他原因无法进行高阻力运动的骨关节炎患者,无负重抗阻联合拉伸运动可能是改善疼痛和功能的一种选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02be/5048036/da88d0394960/BMRI2016-7468937.001.jpg

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