Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, VIC, Australia.
School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
BMC Musculoskelet Disord. 2019 Jun 18;20(1):291. doi: 10.1186/s12891-019-2662-5.
Clinical guidelines recommend exercise as a core treatment for individuals with knee osteoarthritis (OA). However, the best type of exercise for clinical benefits is not clear, particularly in different OA subgroups. Obesity is a common co-morbidity in people with knee OA. There is some evidence suggesting that non-weight bearing exercise may be more effective than weight bearing exercise in patients with medial knee OA and obesity.
To compare the efficacy of two different exercise programs (weight bearing functional exercise and non-weight bearing quadriceps strengthening) on pain and physical function for people ≥50 years with painful medial knee OA and obesity (body mass index ≥30 kg/m) 128 people in Melbourne, Australia will be recruited for a two group parallel-design, assessor- and participant-blinded randomised controlled trial. Participants will be randomly allocated to undertake a program of either weight bearing functional exercise or non-weight bearing quadriceps strengthening exercise. Both groups will attend five individual sessions with a physiotherapist who will teach, monitor and progress the exercise program. Participants will be asked to perform the exercises at home four times per week for 12 weeks. Outcomes will be measured at baseline and 12 weeks. Primary outcomes are self-reported knee pain and physical function. Secondary outcomes include other measures of knee pain, physical function, quality-of-life, participant-perceived global change, physical performance, and lower limb muscle strength.
This study will compare the efficacy of two different 12-week physiotherapist-prescribed, home-based exercise programs for people with medial knee OA and obesity. Findings will provide valuable information to help inform exercise prescription in this common OA patient subgroup.
Australian New Zealand Clinical Trials Registry reference: ACTRN12617001013358 , 14/7/2017.
临床指南建议将运动作为膝骨关节炎(OA)患者的核心治疗方法。然而,对于临床获益而言,哪种运动方式最佳尚不清楚,尤其是在不同的 OA 亚组中。肥胖是膝骨关节炎患者的常见合并症。有一些证据表明,对于内侧膝关节 OA 和肥胖(体重指数≥30kg/m²)患者,非承重运动可能比承重运动更有效。
为了比较两种不同的运动方案(承重功能性运动和非承重股四头肌强化运动)对≥50 岁有疼痛的内侧膝关节 OA 和肥胖(体重指数≥30kg/m²)人群的疼痛和身体功能的疗效,澳大利亚墨尔本将招募 128 名参与者进行两组平行设计、评估者和参与者双盲随机对照试验。参与者将随机分配到承重功能性运动或非承重股四头肌强化运动方案中。两组均将参加 5 次个体治疗,由物理治疗师教授、监测和推进运动方案。参与者将被要求在家中每周进行 4 次运动,持续 12 周。在基线和 12 周时将测量结果。主要结局是自我报告的膝关节疼痛和身体功能。次要结局包括其他膝关节疼痛、身体功能、生活质量、参与者感知的整体变化、身体表现和下肢肌肉力量的测量。
本研究将比较两种不同的 12 周物理治疗师规定的、家庭为基础的运动方案对内侧膝关节 OA 和肥胖患者的疗效。研究结果将提供有价值的信息,有助于为这一常见的 OA 患者亚组提供运动处方建议。
澳大利亚新西兰临床试验注册中心参考号:ACTRN12617001013358,2017 年 7 月 14 日。