Wang K, Chen Y F, Wang H B, Zhang J, Liu Q, Yang Z Y, Xing X, An S L, Lin J H
Arthritis Clinic and Research Center, Peking University People's Hospital, Beijing 100044, China.
Trauma Rescue and Treatment Center, Peking University People's Hospital, Beijing 100044, China.
Zhonghua Yi Xue Za Zhi. 2021 Mar 23;101(11):786-791. doi: 10.3760/cma.j.cn112137-20200619-01897.
To evaluate the effects of neuromuscular exercise therapy on joint stability of knee osteoarthritis (OA) patients. One hundred and ten patients with knee OA were enrolled in this ongoing prospective cohort study at Arthritis Clinic and Research Center, Peking University People's Hospital from September 2017 to October 2018. The treatment consisted of six-week neuromuscular exercise therapy. The participants were followed up at 6 weeks and 3 months after the therapy. The stability of the joint was evaluated by the index of knee joint stability (IKJS), which was extracted by a novel knee-aiming task combined with the multiscale entropy (MSE) analysis of the complexity of the light spot trajectories. The secondary outcomes were pain on the visual analogue scale (VAS, 0-100), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), quality of life on the Euro-quality of life-5 Dimensional (EQ-5D) VAS form, 30-second chair stand test and 40-meter walk test. One-way repeated measures ANOVA analysis was applied to compare the outcomes at baseline and 6 weeks and 3 months. Pearson partial analysis was used to investigate the correlation between the IKJS and the Kellgren-Lawrence (K/L) rate, pain and knee function. Ninety-six participants ((65±8) years, 21 males, 75 females) completed 3-month follow-up. There was a significant improvement in IKJS at the 6-week visit compared with that at baseline (0.369, 95% confidence interval () 0.241-0.496, <0.001). The IKJS dropped at 3-month visit compared with 6-week visit, but was still better than that at baseline (0.178, 95%: 0.042-0.314, =0.008). The correlation between IKJS and K/L rate, severity of pain, WOMAC or knee function was not significant (=-0.131, -0.059, -0.231, 0.124, all >0.05. There was improvement in pain VAS, WOMAC, EQ-5D-VAS, 30-second chair stand test and 40-meter walk test at 6 weeks and 3 months (all <0.05). The neuromuscular exercise therapy is effective in improving the joint stability of the knee OA patients. However, the effect gradually diminished over time. In addition, neuromuscular exercise can help relieve pain, improve the function and quality of life in patients with knee OA.
评估神经肌肉运动疗法对膝关节骨关节炎（OA）患者关节稳定性的影响。2017年9月至2018年10月，110例膝关节OA患者纳入北京大学人民医院关节炎诊疗与研究中心正在进行的前瞻性队列研究。治疗包括为期六周的神经肌肉运动疗法。在治疗后6周和3个月对参与者进行随访。通过膝关节稳定性指数（IKJS）评估关节稳定性，该指数通过一项新颖的膝关节瞄准任务结合光斑轨迹复杂性的多尺度熵（MSE）分析得出。次要结局指标包括视觉模拟评分法（VAS，0 - 100）疼痛评分、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）、欧洲五维健康量表（EQ - 5D）VAS量表的生活质量评分、30秒坐立试验和40米步行试验。采用单向重复测量方差分析比较基线、6周和3个月时的结局指标。采用Pearson偏相关分析研究IKJS与凯尔格伦 - 劳伦斯（K/L）分级、疼痛及膝关节功能之间的相关性。96名参与者（（65±8）岁，男性21名，女性75名）完成了3个月的随访。与基线相比，6周时IKJS有显著改善（0.369，95%置信区间（）0.241 - 0.496，<0.001）。与6周时相比，3个月时IKJS有所下降，但仍优于基线水平（0.178，95%：0.042 - 0.314，=0.008）。IKJS与K/L分级、疼痛严重程度、WOMAC或膝关节功能之间的相关性不显著（= - 0.131， - 0.059， - 0.231，0.124，均>0.05）。6周和3个月时，疼痛VAS、WOMAC、EQ - 5D - VAS、30秒坐立试验和40米步行试验均有改善（均<0.05）。神经肌肉运动疗法可有效改善膝关节OA患者的关节稳定性。然而，随着时间推移，效果逐渐减弱。此外，神经肌肉运动有助于缓解膝关节OA患者的疼痛，改善其功能和生活质量。
