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多组分运动计划对膝关节骨关节炎患者疼痛相关步态适应性的影响。

Effect of multi-component exercises program on pain-related gait adaptations among individuals with osteoarthritis of the knee joint.

作者信息

Bhore Prachiti, Shinde Sandeep

机构信息

Department of Musculoskeletal Sciences, Krishna College of Physiotherapy, Krishna Institute of Medical Sciences Deemed to be University, Karad, Maharashtra, India.

出版信息

J Educ Health Promot. 2023 Apr 28;12:138. doi: 10.4103/jehp.jehp_1628_22. eCollection 2023.

Abstract

BACKGROUND

Osteoarthritis of the knee causes pain and gait disturbances, as well as a distinct gait pattern. Patients with knee OA have decreased range of motion (ROM) and increased ground reaction force. OA reduces stride length and walking speed.

OBJECTIVES

To determine the effect of a multi-component exercise program on pain-related gait adaptations among individuals with osteoarthritis of the knee joint and to compare the effect of multi-component exercises with traditional exercises on pain-related gait adaptations among individuals with osteoarthritis of the knee joint.

MATERIALS AND METHODS

This was an experimental study done between 120 patients having knee OA, of both genders, and between the age group of 50-65 years. These individuals were residents of the city of Karad and they were randomly divided into group A (conventional/traditional) and group B (experimental). A pretest assessment was done and the treatment was given for 6 weeks. The later posttest assessment was done and further statistical tests like paired and unpaired t tests were used.

RESULTS

Among the 120 subjects with OA knee, the age group of 60-65 years (44%) was found to be commonly affected. Thirty-nine were males (32.5%) and 81 were females (67.5%). Fifty-eight subjects (48%) were found to be commonly overweight. Thirty-two subjects (27%) had Genu Valgum deformity, and 88 subjects (73%) had Genu Varum deformity at the knee joint. The Pvalue within both group A and group B was found to be statistically significant for the entire outcome measures used for assessment. The pretest vs post test values of the WOMAC scale for patients with knee OA within both groups were found to be extremely significant ( < 0.0001). As for the MMT score in these patients, the Knee Flexors of Group A were not significant for right side ( = 0.7088) as well as for left side ( = 0.083) and in Group B they were extremely significant ( < 0.0001) for both sides. For the ROM scores within both groups, Knee Flexion of Group A for both sides was found to be extremely significant ( < 0.0001) for both sides. And for the pretest vs posttest values of within the groups'gait parameters among these patients with OA knees, for cadence both groups B were found to be extremely significant ( < 0.0001). The stride length for Group A was found to be very significant ( = 0.0060) and for Group B it was ( < 0.0001). Also, the values of the various outcome measures between both groups were found to have statistical significance of their own.

CONCLUSION

Effect of Multi-Component Exercise Program on Pain-Related Gait Adaptations Among Individuals with Osteoarthritis of the Knee joint was found to be significant in pain reduction, improving strength, range of motion, and the gait parameters such as an increase in cadence, stride length, step length and decrease in the step width.

摘要

背景

膝关节骨关节炎会导致疼痛和步态障碍,以及独特的步态模式。膝骨关节炎患者的关节活动范围(ROM)减小,地面反作用力增加。骨关节炎会缩短步长,降低步行速度。

目的

确定多组分运动计划对膝关节骨关节炎患者疼痛相关步态适应性的影响,并比较多组分运动与传统运动对膝关节骨关节炎患者疼痛相关步态适应性的影响。

材料与方法

这是一项实验研究,研究对象为120名年龄在50 - 65岁之间的膝骨关节炎患者,男女不限。这些患者均为卡拉德市居民,被随机分为A组(传统组)和B组(实验组)。进行了预测试评估,并给予6周的治疗。之后进行了后测试评估,并使用了配对和非配对t检验等进一步的统计测试。

结果

在120名膝骨关节炎受试者中,60 - 65岁年龄组(44%)受影响最为常见。男性39名(32.5%),女性81名(67.5%)。58名受试者(48%)普遍超重。32名受试者(27%)存在膝外翻畸形,88名受试者(73%)存在膝关节内翻畸形。发现A组和B组内所有用于评估的结果指标的P值均具有统计学意义。两组内膝骨关节炎患者WOMAC量表的预测试值与后测试值差异极为显著(<0.0001)。对于这些患者的MMT评分,A组的右侧(=0.7088)和左侧(=0.083)膝关节屈肌不显著,而B组两侧均极为显著(<0.0001)。对于两组内的ROM评分,A组两侧膝关节屈曲均极为显著(<0.0001)。对于这些膝骨关节炎患者组内步态参数的预测试值与后测试值,B组的步频差异极为显著(<0.0001)。A组的步长差异非常显著(=0.0060),B组的步长差异极为显著(<0.0001)。此外,两组之间各种结果指标的值也具有各自的统计学意义。

结论

发现多组分运动计划对膝关节骨关节炎患者疼痛相关步态适应性有显著影响,可减轻疼痛、增强力量、改善活动范围以及改善步态参数,如增加步频、步长、步幅并减小步宽。

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