Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark.
Physiother Theory Pract. 2023 Jun;39(6):1205-1214. doi: 10.1080/09593985.2022.2036885. Epub 2022 Feb 9.
The mechanisms underlying pain reductions following exercise therapy in patients with knee osteoarthritis (OA) are poorly understood. One mechanism could be changes in mechanical knee joint loading.
To investigate if a neuromuscular exercise therapy and patient education intervention could alter knee joint loading assessed by Dual-Energy X-ray Absorptiometry (DXA) in people with knee OA.
Participants with symptomatic knee OA were evaluated before and 26 weeks after an 8-week supervised neuromuscular exercise therapy and patient education intervention (Good Life with OsteoArthritis in Denmark). DXA scans were used to estimate the medial-to-lateral tibial plateau bone mineral density (BMD) ratio. The Knee Injury and Osteoarthritis Outcome Score was used to assess improvements in knee pain, symptoms, physical function, and knee-related quality of life. Changes in physical function were assessed with the 30-second chair stand test and the 40-meter fast paced walk test.
Of 42 participants recruited, 30 (21 females, mean age 64 7.9 years) had full data available. Medial-to-lateral tibial BMD ratio increased non-significantly by 0.02 (95% CI -0.01 to 0.06) (indicating higher medial load) from baseline to 26-weeks follow-up. Participants had statistically significant improvements of 21% in pain, 17% in symptoms, 14% in ADL, 17% in knee-related quality of life, 13% in chair stand ability, and 6% in walking speed.
In this exploratory cohort study, following an 8-weeks supervised exercise therapy and patient education intervention, the medial-to-lateral tibial BMD ratio did not seem to change.
膝关节骨关节炎（OA）患者接受运动疗法后疼痛减轻的机制尚不清楚。一种机制可能是膝关节机械负荷的变化。
研究神经肌肉运动疗法和患者教育干预是否可以改变膝关节 OA 患者的双能 X 射线吸收法（DXA）评估的膝关节负荷。
对有症状的膝关节 OA 患者进行评估，在 8 周的监督神经肌肉运动疗法和患者教育干预（丹麦的 Good Life with OsteoArthritis）之前和 26 周后进行评估。DXA 扫描用于估计内侧到外侧胫骨平台骨密度（BMD）比值。膝关节损伤和骨关节炎结果评分用于评估膝关节疼痛、症状、身体功能和膝关节相关生活质量的改善。身体功能的变化通过 30 秒坐立试验和 40 米快速步行试验进行评估。
在招募的 42 名参与者中，有 30 名（21 名女性，平均年龄 64 7.9 岁）有完整的数据。从基线到 26 周随访，内侧到外侧胫骨 BMD 比值非显著增加 0.02（95%CI-0.01 至 0.06）（表示内侧负荷增加）。参与者的疼痛减轻 21%、症状减轻 17%、ADL 改善 14%、膝关节相关生活质量改善 17%、坐立能力改善 13%、行走速度改善 6%，均具有统计学意义。
在这项探索性队列研究中，经过 8 周的监督运动疗法和患者教育干预，内侧到外侧胫骨 BMD 比值似乎没有变化。
