Department of Physical and Occupational Therapy, Copenhagen University Hospital - Bispebjerg Frederiksberg, Copenhagen NV, Denmark.
Training and Rehabilitation Center, Municipality of Lyngby-Taarbæk, Kgs. Lyngby, Denmark.
Physiother Theory Pract. 2022 Dec;38(12):1946-1957. doi: 10.1080/09593985.2021.1923096. Epub 2021 May 6.
It is believed that clinical management of osteoarthritis should address muscle weakness to improve physical function and prevent disability and frailty.
This sub-study investigated the effects of supervised progressive resistance training (RT), supervised Nordic Walking (NW), and unsupervised home-based exercise (HBE) on muscle and functional performance; and associations between these exercise-induced changes in persons with hip osteoarthritis.
Forty-two patients with hip osteoarthritis were recruited from a larger RCT (NCT01387867). All the groups (RT, = 15; NW, = 12; HBE, = 15) exercised 1 h 3 times/week for 4 months. Quadriceps cross-sectional area (QCSA, MRI-determined); quadriceps strength (QMVC); leg extensor power (LEP); functional performance (chair stands (30sCS); stair climbs (TSC); and 6-minute walk (6MWT)) were assessed at baseline and 4 months.
Per protocol analyses (one-way ANOVA and Bonferroni test) showed significant between-group differences for improvements in QCSA in the most symptomatic leg favoring RT versus NW (2.3 cm, 95% CI [0.6, 3.9]) and HBE (2.3 cm [0.8, 3.9]); and 30sCS (1.8 repetitions [0.2-3.3]), and 6MWT (35.1 m [3.5-66.7]) favoring NW versus HBE. Associations existed between exercise-induced changes in QCSA and QMVC ( = 0.366, = .019) for the most symptomatic leg and between changes in 6MWT and QMVC ( = 0.320, = .04) and LEP ( = 0.381, = .01), respectively, for the least symptomatic leg.
Resistance training appeared effective for improving muscle mass, but less effective for improving muscle strength, power, and functional performance. Only exercise-induced changes in muscle strength and power of the least symptomatic leg, not the most symptomatic leg, were related to changes in functional performance.
人们认为，骨关节炎的临床治疗应该针对肌肉无力，以改善身体功能并预防残疾和虚弱。
本亚研究旨在探讨监督下的渐进式抗阻训练（RT）、监督下的北欧行走（NW）和非监督下的家庭运动（HBE）对肌肉和功能表现的影响；以及这些运动引起的髋关节骨关节炎患者的变化之间的关联。
从一项更大的 RCT（NCT01387867）中招募了 42 名髋关节骨关节炎患者。所有组（RT，n=15；NW，n=12；HBE，n=15）每周运动 3 次，每次 1 小时，共 4 个月。使用 MRI 确定股四头肌横截面积（QCSA）；股四头肌力量（QMVC）；腿部伸肌力量（LEP）；功能表现（30 秒坐站测试（30sCS）；楼梯攀登测试（TSC）；和 6 分钟步行测试（6MWT））在基线和 4 个月时进行评估。
根据方案分析（单因素方差分析和 Bonferroni 检验），在最痛侧腿的 QCSA 改善方面，与 NW 和 HBE 相比，RT 组有显著的组间差异，分别为 2.3 cm（95%置信区间[0.6, 3.9]）和 2.3 cm（95%置信区间[0.8, 3.9]）；30sCS（1.8 次重复[0.2-3.3]）和 6MWT（35.1 m [3.5-66.7]）与 NW 相比，HBE 有优势。在最痛侧腿的 QCSA 和 QMVC（ =0.366， =0.019）之间，以及在最不痛侧腿的 6MWT 和 QMVC（ =0.320， =0.04）和 LEP（ =0.381， =0.01）之间，存在与运动引起的 QCSA 变化相关的关联。
抗阻训练似乎对改善肌肉质量有效，但对改善肌肉力量、力量和功能表现效果不佳。只有最不痛侧腿的肌肉力量和力量的运动引起的变化，而不是最痛侧腿的肌肉力量和力量的运动引起的变化，与功能表现的变化有关。
