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治疗性运动对膝骨关节炎患者疼痛、肌肉力量、功能能力、平衡及血流动力学参数的影响:一项关于监督性运动与家庭运动的随机对照研究

The effects of therapeutic exercises on pain, muscle strength, functional capacity, balance and hemodynamic parameters in knee osteoarthritis patients: a randomized controlled study of supervised versus home exercises.

作者信息

Kuru Çolak Tuğba, Kavlak Bahar, Aydoğdu Onur, Şahin Emir, Acar Gönül, Demirbüken İlkşan, Sarı Zübeyir, Çolak İlker, Bulut Güven, Polat M Gülden

机构信息

Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Marmara University, Başıbüyük Mah. Maltepe Başıbüyük Yolu Sk. Sağlık Bilimleri Fakültesi No:9/4/1 Maltepe, Istanbul, Turkey.

Department of Orthopaedics and Traumatology, Dr Lütfi Kırdar Kartal Training and Research Hospital, Istanbul, Turkey.

出版信息

Rheumatol Int. 2017 Mar;37(3):399-407. doi: 10.1007/s00296-016-3646-5. Epub 2017 Jan 11.

Abstract

The aim of the study was to compare the effects of low-intensity exercise programs for lower extremities, either supervised or at home, on pain, muscle strength, balance and the hemodynamic parameters of knee osteoarthritis (OA) patients. This randomized study included 78 patients with knee OA in 2 groups of supervised and home-based exercise program. Exercises were applied to the first group in the clinic as a group exercise program and were demonstrated to the second group to be performed at home. Before and after the 6-week exercise program, assessment was made of pain, quadriceps and hamstring muscle strengths, 6-min walk test (6MWT), and non-invasive hemodynamic parameters. Results of the 78 patients, 56 completed the study. Pain, muscle strength, and 6MWT scores showed significant improvements in both groups. There were also significant differences in the amount of change in pain and muscle strength (pain: p = 0.041, Rqdc: 0.009, Lqdc: 0.013, Rhms: 0.04) which indicated greater improvements in the supervised group. The balance scores of supervised group showed a significant improvement (p = 0.009). No significant change was determined in hemodynamic parameters of either group. Conclusion according to the results of this study showed that low-intensity lower extremity exercises conducted in a clinic under the supervision of a physiotherapist were more effective than home-based exercises in reducing post-activity pain levels and improving quadriceps and right hamstring muscle strength. Both the supervised and home exercise programs were seen to be effective in reducing rest pain and increasing 6 MW distance in knee osteoarthritis patients.

摘要

本研究的目的是比较针对膝关节骨关节炎(OA)患者,在有监督或居家条件下进行的低强度下肢锻炼计划对疼痛、肌肉力量、平衡能力及血流动力学参数的影响。这项随机研究纳入了78例膝关节OA患者,分为有监督锻炼计划组和居家锻炼计划组。第一组在诊所进行集体锻炼计划,第二组则学习如何在家中进行锻炼。在为期6周的锻炼计划前后,对疼痛、股四头肌和腘绳肌力量、6分钟步行试验(6MWT)以及无创血流动力学参数进行评估。78例患者中,56例完成了研究。两组的疼痛、肌肉力量和6MWT评分均有显著改善。疼痛和肌肉力量的变化量也存在显著差异(疼痛:p = 0.041,右侧股四头肌:0.009,左侧股四头肌:0.013,右侧腘绳肌:0.04),表明有监督组的改善更为明显。有监督组的平衡评分有显著改善(p = 0.009)。两组的血流动力学参数均未发现显著变化。根据本研究结果得出的结论是,在物理治疗师监督下于诊所进行的低强度下肢锻炼,在减轻活动后疼痛水平以及改善股四头肌和右侧腘绳肌力量方面比居家锻炼更有效。有监督和居家锻炼计划在减轻膝关节骨关节炎患者的静息痛和增加6MW距离方面均被证明是有效的。

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