Nakajima Masaaki
Department of Physical Therapy, School of Health Science and Social Welfare, Kibi International University, Takahashi City, Okayama, Japan.
J Chiropr Med. 2017 Jun;16(2):122-130. doi: 10.1016/j.jcm.2016.12.005. Epub 2017 Feb 20.
The purpose of this case series was to describe the short-term and long-term clinical effects of a manual technique for treating osteoarthritis (OA) knee pain.
This study measured of the immediate effect and long-term effect by using a case series of different groups of subjects. Knee OA and activity restriction in patients were evaluated by using the Kellgren-Lawrence (K/L) Grading Scale and the Japanese Knee Osteoarthritis Measure (JKOM) index. In the intervention, lower limb muscles were squeezed by hand for 20 seconds. Each squeeze was performed for both lower limbs. Passive range-of-motion (ROM) exercise was performed on the knee joint. In one set of cases, immediate effects were measured after a one-time treatment with pretreatment and posttreatment outcome measures. Eleven people with knee OA participated in the study. On a visual analogue scale (VAS) for pain, muscle stiffness, and muscular hemodynamics for estimation of muscle blood flow were recorded before and after the squeeze-hold treatment. In another set of cases, the treatment was given to all patients once a week for 6 months, and long-term effects were measured. Data on 5 subjects with knee OA were collected for 6 months after initial treatment. The VAS for pain and JKOM were recorded every month for 6 months.
For immediate effects, the VAS was 69 ± 21 mm before treatment and 26 ± 22 mm after treatment. Muscle stiffness was 8.8 ± 3.6 (absolute number) before treatment and 3.5 ± 2.1 after treatment. Tissue (muscle) oxygen saturation was 60.1 ± 5.7% before treatment and 65.3 ± 4.8% after treatment. Total hemoglobin was 24.3 ± 3.3 (absolute number) before treatment and 25 ± 2.3 after treatment. A tendency for reduction in OA knee pain and muscle stiffness was observed, and a tendency for increase was observed in the blood flow in the muscle. For long-term effects in all 5 participants (any K/L grade, any JKOM score), OA knee pain and JKOM score improved gradually through 6 months.
The participants in this case series showed improvement in pain and function. These findings indicate the feasibility of a larger study on the squeeze-hold intervention for OA knee pain.
本病例系列的目的是描述一种治疗骨关节炎（OA）膝关节疼痛的手法技术的短期和长期临床效果。
本研究通过不同组别的受试者病例系列来测量即时效果和长期效果。使用凯尔格伦-劳伦斯（K/L）分级量表和日本膝关节骨关节炎测量（JKOM）指数评估患者的膝关节OA和活动受限情况。在干预过程中，用手挤压下肢肌肉20秒。对双下肢都进行每次挤压。对膝关节进行被动活动范围（ROM）锻炼。在一组病例中，在一次治疗后，通过治疗前和治疗后的结果测量来评估即时效果。11名膝关节OA患者参与了该研究。在挤压-保持治疗前后，记录疼痛的视觉模拟量表（VAS）、肌肉僵硬程度以及用于评估肌肉血流的肌肉血液动力学情况。在另一组病例中，对所有患者每周治疗一次，持续6个月，并测量长期效果。在初始治疗后的6个月内收集了5名膝关节OA患者的数据。在6个月内每月记录疼痛的VAS和JKOM。
对于即时效果，治疗前VAS为69±21毫米，治疗后为26±22毫米。治疗前肌肉僵硬程度为8.8±3.6（绝对值），治疗后为3.5±2.1。治疗前组织（肌肉）氧饱和度为60.1±5.7%，治疗后为65.3±4.8%。治疗前总血红蛋白为24.3±3.3（绝对值），治疗后为25±2.3。观察到OA膝关节疼痛和肌肉僵硬程度有减轻趋势，肌肉血流有增加趋势。对于所有5名参与者（任何K/L等级，任何JKOM评分）的长期效果，OA膝关节疼痛和JKOM评分在6个月内逐渐改善。
本病例系列中的参与者在疼痛和功能方面有所改善。这些发现表明对OA膝关节疼痛进行挤压-保持干预的更大规模研究具有可行性。
