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一项针对髋骨关节炎患者的 12 周运动计划对步态参数没有影响:一项随机对照试验的二次分析。

A 12-week exercise program for patients with hip osteoarthritis has no influence on gait parameters: A secondary analysis of a randomized controlled trial.

机构信息

Medical Clinic, Department of Sports Medicine, University of Tuebingen, Germany; Interfaculty Research Institute for Sports and Physical Activity Tuebingen, Department of Sports Medicine, University Hospital Tuebingen, Germany.

Analyz3d, Basel, Switzerland.

出版信息

Gait Posture. 2020 May;78:6-12. doi: 10.1016/j.gaitpost.2020.03.001. Epub 2020 Mar 3.

Abstract

BACKGROUND

Hip osteoarthritis is a major musculoskeletal disorder in the elderly. Evidence is given for the efficacy of exercise interventions in terms of self-reported physical functioning and pain. However, it has not yet been fully examined whether exercises influence gait.

RESEARCH QUESTION

The purpose of this RCT therefore was to evaluate effects of a 12-week exercise program on kinematic gait variables in subjects with hip osteoarthritis.

METHODS

210 participants were randomly assigned to exercise, non-treated control, or placebo ultrasound groups. The 12-week exercise intervention combined a weekly group session with home-based exercises (2/week), which entailed exercises for motor learning, flexibility, strengthening, and balance. Placebo ultrasound was given once a week. A 6-camera motion capture system was used for data collection. Data were derived from shod walking at self-selected speeds. Spatio-temporal and hip and knee joint angles of the stance phase were calculated. Data were averaged across five trials. Measurements were taken prior to and immediately after the intervention period. ANOVA/Kruskall-Wallis-Tests were used to analyze between-group effects for differences between test days. Pairwise comparisons were subsequently conducted in case of significant model effects. Data were analyzed per protocol (n = 185).

RESULTS

No statistically significant differences were detected for any of the outcome measures.

SIGNIFICANCE

Although hip muscle strength and gait quality are related, strength training of the hip-surrounding musculature without specific gait training elements cannot improve spatio-temporal gait characteristics or hip and knee joint angles in subjects with mild to moderate hip osteoarthritis. If gait should explicitly be improved through exercise, interventions must incorporate a relevant portion of gait-related tasks.

摘要

背景

髋骨关节炎是老年人中一种主要的肌肉骨骼疾病。有证据表明,运动干预在自我报告的身体机能和疼痛方面是有效的。然而,运动是否会影响步态还没有得到充分的研究。

研究问题

因此,本 RCT 的目的是评估为期 12 周的运动计划对髋骨关节炎患者运动学步态变量的影响。

方法

210 名参与者被随机分配到运动组、非治疗对照组或安慰剂超声组。为期 12 周的运动干预结合了每周一次的小组会议和基于家庭的运动(每周 2 次),包括运动学习、柔韧性、力量和平衡练习。每周进行一次安慰剂超声治疗。使用 6 个摄像机运动捕捉系统进行数据采集。数据来自穿着鞋子以自我选择的速度行走。计算了站立阶段的时空和髋关节、膝关节角度。数据是在干预前后 5 次试验的平均值。在干预期间之前和之后进行测量。采用方差分析/克鲁斯卡尔-沃利斯检验分析组间差异。在模型效应显著的情况下,随后进行了两两比较。根据方案进行数据分析(n = 185)。

结果

在任何结果测量中都没有检测到统计学上的显著差异。

意义

尽管髋部肌肉力量和步态质量有关,但不包括特定步态训练元素的髋部周围肌肉力量训练不能改善轻度至中度髋骨关节炎患者的时空步态特征或髋关节和膝关节角度。如果要通过运动明确改善步态,干预措施必须包含与步态相关任务的相关部分。

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