Sharma Meenakshi, Singh Amarjeet, Dhillon Mandeep Singh, Kaur Sukhpal
School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Department of Community Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Palliat Care. 2018 Oct-Dec;24(4):478-485. doi: 10.4103/IJPC.IJPC_14_18.
Nonpharmacological interventions (NPIs) have been advocated for knee osteoarthritis (KOA). There are many gaps in the evidence to their efficacy in India.
The study aims to compare the impact of two packages of NPIs on various outcome variables of KOA patients.
This was a randomized controlled trial in a tertiary care hospital.
A study population ( = 123) of KOA patients aged 40-65 years. Stratified block randomization was done for mild or moderate KOA into two groups. Group "A" patients received a package of NPIs including a set of supervised exercise sessions, kinesthesia, balance, and agility (KBA), meditation, weight reduction advice, and weekly telephonic reminders. Group "B" patients received the same package except for KBA & meditation. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analog scale (VAS) and performance-based measures were measured.
-test and repeat measures ANOVA were undertaken.
A significant intragroup reduction in WOMAC score was seen from baseline in Group A ( = 0.00, mean difference: -9.7) as well as in Group B ( = 0.00, -12.9). There was also significant reduction inVAS scores at the end of intervention in Group A and Group B as compared from baseline (-3.62, -3.8, = 0.00). No intergroup difference was observed in either of the scores. VAS score reduction to 0 at different stages of intervention was noticed in 46% ( = 57) cases. There was a significant intergroup difference for 50-Foot Walk Test ( = 0.055, F = 3.28) at 12 months.
Both packages of NPIs were effective in providing relief in symptoms. No specific benefit of KBA or meditation was seen except for 50FWT.
非药物干预（NPIs）已被推荐用于膝关节骨关节炎（KOA）。在印度，关于其疗效的证据存在许多空白。
本研究旨在比较两种非药物干预方案对KOA患者各种结局变量的影响。
这是一项在三级护理医院进行的随机对照试验。
123名年龄在40 - 65岁的KOA患者作为研究人群。将轻度或中度KOA患者通过分层区组随机化分为两组。A组患者接受一套非药物干预方案，包括一组有监督的锻炼课程、动觉、平衡和敏捷性训练（KBA）、冥想、减重建议以及每周电话提醒。B组患者接受相同的方案，但不包括KBA和冥想。采用西安大略和麦克马斯特大学骨关节炎指数（WOMAC）、视觉模拟量表（VAS）以及基于表现的测量方法进行评估。
采用t检验和重复测量方差分析。
A组（P = 0.00，平均差值：-9.7）和B组（P = 0.00，-12.9）从基线开始，组内WOMAC评分均有显著降低。与基线相比，A组和B组在干预结束时VAS评分也有显著降低（-3.62，-3.8，P = 0.00）。两组评分均未观察到组间差异。在46%（n = 57）的病例中，干预不同阶段VAS评分降至0。在12个月时，50英尺步行测试存在显著组间差异（P = 0.055，F = 3.28）。
两种非药物干预方案在缓解症状方面均有效。除50英尺步行测试外，未观察到KBA或冥想有特定益处。
