太极拳训练对中国老年膝骨关节炎女性步态运动学的影响：一项随机对照试验。
Effects of Tai Ji Quan training on gait kinematics in older Chinese women with knee osteoarthritis: A randomized controlled trial.
作者信息
Zhu Qingguang, Huang Lingyan, Wu Xie, Wang Lin, Zhang Yunya, Fang Min, Liu Yu, Li Jing Xian
机构信息
Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai 200438, China.
Department of Physical Therapy with Chinese Massage, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China.
出版信息
J Sport Health Sci. 2016 Sep;5(3):297-303. doi: 10.1016/j.jshs.2016.02.003. Epub 2016 Feb 15.
BACKGROUND
Although Tai Ji Quan has been shown to relieve pain and improve functional mobility in people with knee osteoarthritis (OA), little is known about its potential benefits on gait characteristics among older Chinese women who have a high prevalence of both radiographic and symptomatic knee OA. This study aims to assess the efficacy of a tailored Tai Ji Quan intervention on gait kinematics for older Chinese women with knee OA.
METHODS
A randomized controlled trial involving 46 older women in Shanghai, China, with clinically diagnosed knee OA. Randomized (1:1) participants received either a 60 min Tai Ji Quan session ( = 23) 3 times weekly or a 60 min bi-weekly educational session ( = 23) for 24 weeks. Primary outcomes were changes in gait kinematic measures from baseline to 24 weeks. Secondary outcomes included changes in scores on the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and Short Physical Performance Battery (SPPB).
RESULTS
After 24 weeks the Tai Ji Quan group demonstrated better performance in gait velocity (mean difference, 8.40 cm/s, = 0.01), step length (mean difference, 3.52 cm, = 0.004), initial contact angle (mean difference, 2.19°, = 0.01), and maximal angle (mean difference, 2.61°, = 0.003) of flexed knees during stance phase compared to the control group. In addition, the Tai Ji Quan group showed significant improvement in WOMAC scores ( < 0.01) (mean difference, -4.22 points in pain, = 0.002; -2.41 points in stiffness, < 0.001; -11.04 points in physical function, = 0.006) and SPPB scores (mean difference, 1.22 points, < 0.001).
CONCLUSION
Among older Chinese women with knee OA, a tailored Tai Ji Quan intervention improved gait outcomes. The intervention also improved overall function as indexed by the WOMAC and SPPB. These results support the use of Tai Ji Quan for older Chinese adults with knee OA to both improve their functional mobility and reduce pain symptomatology.
背景
尽管太极拳已被证明可缓解膝关节骨关节炎（OA）患者的疼痛并改善功能活动能力，但对于中国老年女性（她们中膝关节OA的影像学表现和症状性OA的患病率都很高）的步态特征的潜在益处却知之甚少。本研究旨在评估针对患有膝关节OA的中国老年女性量身定制的太极拳干预对步态运动学的疗效。
方法
一项随机对照试验，纳入了46名来自中国上海、临床诊断为膝关节OA的老年女性。参与者被随机（1:1）分为两组，一组每周接受3次、每次60分钟的太极拳课程（n = 23），另一组每两周接受一次60分钟的健康教育课程（n = 23），为期24周。主要结局指标是从基线到24周步态运动学测量指标的变化。次要结局指标包括西安大略和麦克马斯特大学骨关节炎指数（WOMAC）以及简短体能状况量表（SPPB）评分的变化。
结果
24周后，与对照组相比，太极拳组在步态速度（平均差异为8.40 cm/s，P = 0.01）、步长（平均差异为3.52 cm，P = 0.004）、站立期屈膝初始接触角度（平均差异为2.19°，P = 0.01）和最大角度（平均差异为2.61°，P = 0.003）方面表现更好。此外，太极拳组的WOMAC评分（P < 0.01）有显著改善（疼痛平均差异为 -4.22分，P = 0.002；僵硬平均差异为 -2.41分，P < 0.001；身体功能平均差异为 -11.04分，P = 0.006）以及SPPB评分（平均差异为1.22分，P < 0.001）。
结论
在患有膝关节OA的中国老年女性中，量身定制的太极拳干预改善了步态结局。该干预还改善了以WOMAC和SPPB为指标的整体功能。这些结果支持对患有膝关节OA的中国老年人使用太极拳来改善其功能活动能力并减轻疼痛症状。
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