Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada.
School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada.
PLoS One. 2018 Apr 17;13(4):e0195653. doi: 10.1371/journal.pone.0195653. eCollection 2018.
Certain exercises could overload the osteoarthritic knee. We developed an exercise program from yoga postures with a minimal knee adduction moment for knee osteoarthritis. The purpose was to compare the effectiveness of this biomechanically-based yoga exercise (YE), with traditional exercise (TE), and a no-exercise attention-equivalent control (NE) for improving pain, self-reported physical function and mobility performance in women with knee osteoarthritis.
Single-blind, three-arm randomized controlled trial.
Community in Southwestern Ontario, Canada.
A convenience sample of 31 women with symptomatic knee osteoarthritis was recruited through rheumatology, orthopaedic and physiotherapy clinics, newspapers and word-of-mouth.
Participants were stratified by disease severity and randomly allocated to one of three 12-week, supervised interventions. YE included biomechanically-based yoga exercises; TE included traditional leg strengthening on machines; and NE included meditation with no exercise. Participants were asked to attend three 1-hour group classes/sessions each week.
Primary outcomes were pain, self-reported physical function and mobility performance. Secondary outcomes were knee strength, depression, and health-related quality of life. All were assessed by a blinded assessor at baseline and immediately following the intervention.
The YE group demonstrated greater improvements in KOOS pain (mean difference of 22.9 [95% CI, 6.9 to 38.8; p = 0.003]), intermittent pain (mean difference of -19.6 [95% CI, -34.8 to -4.4; p = 0.009]) and self-reported physical function (mean difference of 17.2 [95% CI, 5.2 to 29.2; p = 0.003]) compared to NE. Improvements in these outcomes were similar between YE and TE. However, TE demonstrated a greater improvement in knee flexor strength compared to YE (mean difference of 0.1 [95% CI, 0.1 to 0.2]. Improvements from baseline to follow-up were present in quality of life score for YE and knee flexor strength for TE, while both also demonstrated improvements in mobility. No improvement in any outcome was present in NE.
The biomechanically-based yoga exercise program produced clinically meaningful improvements in pain, self-reported physical function and mobility in women with clinical knee OA compared to no exercise. While not statistically significant, improvements in these outcomes were larger than those elicited from the traditional exercise-based program. Though this may suggest that the yoga program may be more efficacious for knee OA, future research studying a larger sample is required.
ClinicalTrials.gov (NCT02370667).
某些运动可能会使骨关节炎的膝盖超负荷。我们从瑜伽姿势中开发了一个运动方案，该方案的膝关节内收力矩最小，适用于膝骨关节炎。目的是比较这种基于生物力学的瑜伽运动（YE）与传统运动（TE）和无运动等效对照组（NE）在改善疼痛，自我报告的身体功能和膝关节骨关节炎女性的活动能力方面的有效性。
单盲，三臂随机对照试验。
加拿大安大略省西南部社区。
通过风湿病，骨科和物理治疗诊所，报纸和口口相传，招募了 31 名有症状的膝骨关节炎的便利样本妇女。
根据疾病严重程度对参与者进行分层，并随机分配到三个为期 12 周，监督的干预措施之一。YE 包括基于生物力学的瑜伽运动；TE 包括在机器上进行传统的腿部强化运动；NE 包括无运动的冥想。要求参与者每周参加三次 1 小时的小组课/课程。
主要结果是疼痛，自我报告的身体功能和活动能力。次要结果是膝关节力量，抑郁和健康相关的生活质量。所有这些都由盲法评估者在基线和干预后立即进行评估。
与 NE 相比，YE 组在 KOOS 疼痛（平均差异 22.9 [95％CI，6.9 至 38.8；p = 0.003]），间歇性疼痛（平均差异-19.6 [95％CI，-34.8 至-4.4；p = 0.009）和自我报告的身体功能（平均差异 17.2 [95％CI，5.2 至 29.2；p = 0.003]）方面均有更大的改善。YE 与 TE 相比，这些结果的改善相似。但是，TE 与 YE 相比，膝关节伸肌力量的改善更大（平均差异为 0.1 [95％CI，0.1 至 0.2]）。YE 的生活质量评分和 TE 的膝关节伸肌力量从基线到随访均有改善，而两者均改善了活动能力。NE 没有任何结果改善。
与不运动相比，基于生物力学的瑜伽运动方案可使临床膝关节 OA 女性的疼痛，自我报告的身体功能和活动能力得到临床意义上的改善。虽然没有统计学意义，但这些结果的改善大于从传统运动方案中得出的改善。尽管这可能表明瑜伽方案对膝骨关节炎更有效，但需要进一步研究更大样本量的研究。
ClinicalTrials.gov（NCT02370667）。
