膝关节骨关节炎患者使用软膝支具对疼痛、活动受限、自我报告的膝关节不稳定和自我报告的膝关节信心的即时影响。
The immediate effect of a soft knee brace on pain, activity limitations, self-reported knee instability, and self-reported knee confidence in patients with knee osteoarthritis.
机构信息
Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands.
Amsterdam Rehabilitation Research Centre Reade, Dr. J. van Breemenstraat 2, 1056 AB Amsterdam, P.O. Box 58271, 1040 HG, Amsterdam, The Netherlands.
出版信息
Arthritis Res Ther. 2017 Dec 1;19(1):260. doi: 10.1186/s13075-017-1456-0.
BACKGROUND
We aimed to (i) evaluate the immediate effect of a soft knee brace on pain, activity limitations, self-reported knee instability, and self-reported knee confidence, and (ii) to assess the difference in effect between a non-tight and a tight soft brace in patients with knee osteoarthritis (OA).
METHODS
Forty-four patients with knee OA and self-reported knee instability participated in the single-session, laboratory, experimental study. A within-subject design was used, comparing a soft brace with no brace, and comparing a non-tight with a tight soft brace. The outcome measures were pain, self-reported knee instability and knee confidence during level and perturbed walking on the treadmill and activity limitations (10-m walk test and the get up and go (GUG) test). Linear mixed-effect model analysis for continuous outcomes and logistic generalized estimating equations for categorical outcomes were used to evaluate the effect of wearing a soft brace.
RESULTS
Wearing a soft brace significantly reduced pain during level walking (B - 0.60, P = 0.001) and perturbed walking (B - 0.80, P < 0.001), reduced the time to complete the 10-m walk (B - 0.23, P < 0.001) and the GUG tests (B - 0.23, P = 0.004), reduced self-reported knee instability during level walking (OR 0.41, P = 0.002) and perturbed walking (OR 0.36, P < 0.001), and reduced lack of confidence in the knees during level walking (OR 0.45, P < 0.001) and perturbed walking (OR 0.56, P < 0.001), compared with not wearing a soft brace. There was no difference in effects between a non-tight and tight brace, except for the 10-m walk test. Wearing a tight brace significantly reduced the time to complete the 10-m walk test in comparison with wearing a non-tight brace (B - 0.11, P = 0.03).
CONCLUSION
The results of this study indicate that a soft brace is an efficacious intervention targeting pain, activity limitations, self-reported knee instability, and knee confidence in the immediate term in patients with knee OA. Further studies are needed evaluating the mode of action based on exerted pressure, and on the generalization to functioning in daily life.
TRIAL REGISTRATION
trialregister.nl, NTR6363 . Retrospectively registered on 15 May 2017.
背景
本研究旨在（i）评估软膝支撑对膝骨关节炎（OA）患者疼痛、活动受限、自我报告的膝关节不稳定和自我报告的膝关节信心的即时影响，以及（ii）评估非紧绷和紧绷软支撑之间的效果差异。
方法
44 名患有膝关节 OA 和自我报告的膝关节不稳定的患者参加了单例、实验室、实验研究。采用自身对照设计，比较了软支撑与无支撑，以及非紧绷软支撑与紧绷软支撑。主要结局指标包括在跑步机上进行水平和扰动行走时的疼痛、自我报告的膝关节不稳定和膝关节信心，以及活动受限（10 米步行测试和起身行走测试）。采用线性混合效应模型分析连续结果，采用逻辑广义估计方程分析分类结果，以评估佩戴软支撑的效果。
结果
佩戴软支撑可显著减轻水平行走（B=-0.60，P=0.001）和扰动行走（B=-0.80，P<0.001）时的疼痛，缩短 10 米步行（B=-0.23，P<0.001）和起身行走测试（B=-0.23，P=0.004）的完成时间，降低水平行走（OR 0.41，P=0.002）和扰动行走（OR 0.36，P<0.001）时的自我报告膝关节不稳定，以及水平行走（OR 0.45，P<0.001）和扰动行走（OR 0.56，P<0.001）时的膝关节缺乏信心。与不佩戴软支撑相比，佩戴非紧绷和紧绷支撑在除 10 米步行测试外，其余结果之间均无差异。与佩戴非紧绷支撑相比，佩戴紧绷支撑可显著缩短 10 米步行测试的完成时间（B=-0.11，P=0.03）。
结论
本研究结果表明，软膝支撑在膝关节 OA 患者中具有即时减轻疼痛、活动受限、自我报告的膝关节不稳定和膝关节信心的疗效。需要进一步研究基于施加压力的作用机制，并将其推广到日常生活中的功能。
试验注册
trialregister.nl，NTR6363。2017 年 5 月 15 日进行了回顾性注册。
Zotero 插件