特定手法治疗结合监督运动方案对膝关节骨关节炎患者疼痛强度和功能障碍的管理效果
Efficacy of Specified Manual Therapies in Combination with a Supervised Exercise Protocol for Managing Pain Intensity and Functional Disability in Patients with Knee Osteoarthritis.
作者信息
Reza Mohammad Kashif, Shaphe Mohammad Abu, Qasheesh Mohammed, Shah Mudasir Nazar, Alghadir Ahmad H, Iqbal Amir
机构信息
Physical Therapy Department, Jazan University, Jazan, Saudi Arabia.
Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
出版信息
J Pain Res. 2021 Jan 26;14:127-138. doi: 10.2147/JPR.S285297. eCollection 2021.
PURPOSE
The current study aimed to determine the efficacy of specified manual therapies in combination with a supervised exercise protocol for managing pain intensity and functional disability in patients with knee osteoarthritis.
METHODS
The study was based on a two-arm parallel-group randomized controlled trial design, including a total of 32 participants with knee osteoarthritis randomly divided into groups A and B. Group A received a supervised exercise protocol; however, group B received specified manual therapies in combination with a supervised exercise protocol. Pain and functional disability were measured with the numeric pain rating scale (NPRS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), respectively. Data were collected at baseline (pre-intervention), 2 weeks, and 4 weeks post-intervention. To evaluate the efficacy of specific manual therapies with supervised exercise compared to supervised exercise alone, an unpaired -test and repeated measures ANOVA were used to analyze the data, keeping the level of significance at p<0.05.
RESULTS
A significant (p<0.05) mean difference (∆MD) was found within group A and group B for both outcomes when we compared their baseline scores with 2-week (group A, NPRS: ∆MD=-1.56 and WOMAC: ∆MD=14.94; group B, NPRS: ∆MD=2.06 and WOMAC: ∆MD=22.19) and 4-week post-intervention scores (group A, NPRS: ∆MD=0.62 and WOMAC: ∆MD=6.75; group B, NPRS: ∆MD=0.75 and WOMAC: ∆MD=11.12). In addition, significant mean differences (p<0.05) reported for both outcomes when we compared their scores between groups A and B at 2 weeks (∆MD: NPRS=0.69; WOMAC=10.87) and 4 weeks post-intervention (∆MD: NPRS=0.31; WOMAC=8.00). Furthermore, a post hoc Scheffe analysis for the outcomes NPRS and WOMAC revealed the superiority of group B over group A.
CONCLUSION
The specified manual therapies, in combination with a supervised exercise protocol, were found to be more effective than a supervised exercise protocol alone for improving pain and functional disability in patients with knee osteoarthritis.
目的
本研究旨在确定特定手法治疗与监督下的运动方案相结合对膝关节骨关节炎患者疼痛强度和功能障碍的管理效果。
方法
该研究基于双臂平行组随机对照试验设计，共有32名膝关节骨关节炎患者随机分为A组和B组。A组接受监督下的运动方案；然而，B组接受特定手法治疗与监督下的运动方案相结合。分别使用数字疼痛评分量表（NPRS）和西安大略和麦克马斯特大学骨关节炎指数（WOMAC）测量疼痛和功能障碍。在基线（干预前）、干预后2周和4周收集数据。为了评估特定手法治疗与监督下的运动相比单独监督下的运动的疗效，使用未配对t检验和重复测量方差分析来分析数据，显著性水平保持在p<0.05。
结果
当我们将A组和B组的基线评分与干预后2周（A组，NPRS：∆MD=-1.56，WOMAC：∆MD=14.94；B组，NPRS：∆MD=2.06，WOMAC：∆MD=22.19）和4周的评分（A组，NPRS：∆MD=0.62，WOMAC：∆MD=6.75；B组，NPRS：∆MD=0.75，WOMAC：∆MD=11.12）进行比较时，发现两组在两个结果上均存在显著（p<0.05）的平均差异（∆MD）。此外，当我们比较A组和B组在干预后2周（∆MD：NPRS=0.69；WOMAC=10.87）和4周的评分时，两个结果均报告了显著的平均差异（p<0.05）（∆MD：NPRS=0.31；WOMAC=8.00）。此外，对NPRS和WOMAC结果的事后Scheffe分析显示B组优于A组。
结论
发现特定手法治疗与监督下的运动方案相结合比单独的监督下的运动方案在改善膝关节骨关节炎患者的疼痛和功能障碍方面更有效。
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