Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China.
Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, China.
J Back Musculoskelet Rehabil. 2021;34(6):1007-1014. doi: 10.3233/BMR-191799.
Active exercise is the only proven effective intervention for knee osteoarthritis (OA). The addition of manual therapy has shown to improve outcome of exercises. Passive mobilization with submaximal bilateral passive ankle dorsiflexion was examined in a double-blinded randomized controlled clinical trial. A passive ankle dorsiflexion apparatus was used to standardize the frequency, range of motion, and duration parameters.
The purpose of the study was to determine whether a simple standardised mobilization technique could be incorporated as a safe and unsupervised conservative treatment for knee OA.
In total, 73 participants were randomly assigned to the experimental (n= 37) or control group (n= 36). All participants performed active exercises and received six sessions of 10-minute dorsiflexion intervention, either real or sham, for two weeks. Pre- and post-experimental assessments for the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analog scale (VAS) for pain, and range of motion of the knee were conducted.
Results were analyzed using two-way repeated measures analysis of variance and Independent-Samples Mann-Whitney U Test. The mean score of WOMAC for the experimental and control groups changed from 31.84 to 18.19 and 34.74 to 21.06, respectively, after the intervention. The VAS also showed significant improvements. Significant improvements were observed in WOMAC in both groups after the intervention; however, differences between the groups were not statistically significant.
Exercise with either 30∘ or 5∘ of passive dorsiflexion yielded favorable clinical effects. Although submaximal bilateral ankle dorsiflexion was proven to be safe for elderly participants with osteoarthritis of the knee, whether it provided extra benefits to exercises alone was unclear. Further research is required to determine the effectiveness of dorsiflexion and optimal range of mobilization.
主动运动是治疗膝骨关节炎（OA）的唯一有效干预措施。添加手法治疗已显示出可改善运动的结果。在一项双盲随机对照临床试验中，检查了双侧被动踝关节背屈的亚最大被动运动。使用被动踝关节背屈仪来标准化频率、运动范围和持续时间参数。
本研究旨在确定一种简单的标准化松动技术是否可以作为膝骨关节炎的安全和非监督保守治疗方法。
共有 73 名参与者被随机分配到实验组（n=37）或对照组（n=36）。所有参与者均进行主动运动，并接受 10 分钟的背屈干预，无论是真实的还是虚假的，共 2 周，6 次。在实验前和实验后，对 Western Ontario 和 McMaster 大学骨关节炎指数（WOMAC）、疼痛视觉模拟量表（VAS）和膝关节活动范围进行评估。
使用双向重复测量方差分析和独立样本曼-惠特尼 U 检验对结果进行分析。实验组和对照组的 WOMAC 平均评分分别从干预前的 31.84 分降至 18.19 分和 34.74 分降至 21.06 分。VAS 也显示出显著的改善。干预后两组 WOMAC 均有显著改善，但组间差异无统计学意义。
进行 30°或 5°的被动背屈运动结合主动运动可产生良好的临床效果。虽然双侧踝关节背屈至亚最大程度已被证明对患有膝关节骨关节炎的老年参与者是安全的，但它是否能单独增加运动的益处尚不清楚。需要进一步研究来确定背屈的有效性和最佳活动范围。
