Farrokhi Shawn, Jayabalan Prakash, Gustafson Jonathan A, Klatt Brian A, Sowa Gwendolyn A, Piva Sara R
DOD/VA Extremity Trauma and Amputation Center of Excellence, Naval Medical Center San Diego, 34800 Bob Wilson Dr., San Diego, CA, 92134, USA.
Rehabilitation Institute of Chicago, USA.
Gait Posture. 2017 Jul;56:129-133. doi: 10.1016/j.gaitpost.2017.05.015. Epub 2017 May 17.
To evaluate whether knee contact force and knee pain are different between continuous and interval walking exercise in patients with knee osteoarthritis (OA).
Twenty seven patients with unilateral symptomatic knee OA completed two separate walking exercise sessions on a treadmill at 1.3m/s on two different days: 1) a continuous 45min walking exercise session, and 2) three 15min bouts of walking exercise separated by 1h rest periods for a total of 45min of exercise in an interval format. Estimated knee contact forces using the OpenSim software and knee pain were evaluated at baseline (1st minute of walking) and after every 15min between the continuous and interval walking conditions.
A significant increase from baseline was observed in peak knee contact force during the weight-acceptance phase of gait after 30 and 45min of walking, irrespective of the walking exercise condition. Additionally, whereas continuous walking resulted in an increase in knee pain, interval walking did not lead to increased knee pain.
Walking exercise durations of 30min or greater may lead to undesirable knee joint loading in patients with knee OA, while performing the same volume of exercise in multiple bouts as opposed to one continuous bout may be beneficial for limiting knee pain.
评估膝关节骨关节炎（OA）患者进行持续步行锻炼和间歇步行锻炼时，膝关节接触力和膝关节疼痛是否存在差异。
27例单侧有症状的膝关节OA患者在两天内，以1.3m/s的速度在跑步机上完成两次不同的步行锻炼：1）一次持续45分钟的步行锻炼；2）三次15分钟的步行锻炼，每次锻炼之间休息1小时，总共45分钟的间歇式锻炼。在基线时（步行第1分钟）以及在持续步行和间歇步行条件下，每隔15分钟评估一次使用OpenSim软件估计的膝关节接触力和膝关节疼痛情况。
无论步行锻炼条件如何，在步行30分钟和45分钟后，步态负重期的膝关节峰值接触力均较基线有显著增加。此外，持续步行会导致膝关节疼痛加剧，而间歇步行不会导致膝关节疼痛增加。
步行锻炼持续时间达30分钟或更长时间可能会给膝关节OA患者带来不良的膝关节负荷，而将相同运动量分成多次进行，而非一次持续完成，可能有利于减轻膝关节疼痛。
