Department of Rehabilitation Medicine, Yue Bei People's Hospital, 512000 ShaoGuan, China.
J Rehabil Med. 2018 Jun 15;50(6):534-541. doi: 10.2340/16501977-2340.
To study the effect of therapeutic exercise on knee osteoarthritis after injection of botulinum toxin type A, hyaluronate or saline.
Sixty participants with knee osteoarthritis were randomly assigned to 3 groups: injection of saline (control) (group A), botulinum toxin type A (group B), or hyaluronate (group C). All participants received therapeutic exercise. Western Ontario and McMaster Universities Osteoarthritis Index questionnaire score, visual analogue scale pain scale, and Medical Outcomes Study 36-item Health Survey were conducted at baseline, and at the end of the 4th and 8th weeks.
At end of the 4th and 8th weeks, the scores on the Western Ontario and McMaster Universities Osteoarthritis Index questionnaire and visual analogue scale were higher in the control group. There were significant differences in Physical Component Summary-36 and Mental Component Summary-36 scores between the 3 groups (p <0.05) at the end of the 4th and 8th weeks, but not between groups A (control) and C (hyaluronate) at the end of the 4th week. No changes were seen on magnetic resonance imaging and X-ray images of the affected knees after the intervention.
Therapeutic exercise plus botulinum toxin type A or hyaluronate injection can significantly reduce pain and improve knee functioning. Botulinum toxin type A plus therapeutic exercise appears to be more effective.
研究肉毒毒素 A、透明质酸或生理盐水注射后治疗性运动对膝骨关节炎的影响。
将 60 名膝骨关节炎患者随机分为 3 组：生理盐水（对照）（A 组）、肉毒毒素 A（B 组）或透明质酸（C 组）。所有参与者均接受治疗性运动。在基线时、第 4 周和第 8 周时进行 Western Ontario 和 McMaster 大学骨关节炎指数问卷评分、视觉模拟量表疼痛评分和医疗结局研究 36 项健康调查。
第 4 周和第 8 周时，对照组 Western Ontario 和 McMaster 大学骨关节炎指数问卷和视觉模拟量表评分较高。第 4 周和第 8 周时，3 组之间生理成分综合评分-36 和心理成分综合评分-36 评分存在显著差异（p <0.05），但第 4 周时 A 组（对照组）和 C 组（透明质酸）之间无差异。干预后，受累膝关节的磁共振成像和 X 线图像无变化。
治疗性运动加肉毒毒素 A 或透明质酸注射可显著减轻疼痛，改善膝关节功能。肉毒毒素 A 加治疗性运动似乎更有效。
