家庭为基础的运动计划和健康教育对髌股疼痛患者的影响：一项随机对照试验。
Home-based exercise program and Health education in patients with patellofemoral pain: a randomized controlled trial.
机构信息
Department of Sport Medicine, Sichuan Province Orthopedic Hospital, Chengdu, Sichuan Province, China.
Faculty of Sport Medicine and Rehabilitation, Beijing Sport University, Beijing, China.
出版信息
BMC Musculoskelet Disord. 2023 Nov 18;24(1):896. doi: 10.1186/s12891-023-07027-z.
BACKGROUND
Patellofemoral pain (PFP) is one of the most common disorders of the knee joint. Home-based exercise is an effective intervention to achieve self-management for chronic diseases. This study evaluated the effects of home-based exercise and health education in patients with PFP.
METHODS
Patients who had PFP were randomly allocated to an intervention group (IG) or control group (CG). Patients in the IG received a 6-week tailored home-based exercise program with health education via remote support, while patients in the CG group only received health education. Clinical outcomes were compared using the Anterior Knee Pain Scale (AKPS) to measure function and the Visual Analog Scale (VAS) to measure "worst pain" and "pain with daily activity". Muscle strength was measured according to the peak torque of the knee muscles using an isokinetic system.
RESULTS
Among a total of 112 participants screened for eligibility, 38 were randomized and analyzed, including 19 participants in the intervention group and 19 participants in the control group. There were no significant differences in baseline characteristics between the groups. At 6-week follow-up, the intervention group showed a greater worst pain reduction (between-group difference, -19.3 [95%CI, -23.2 to -15.5]; P < 0.01) and pain with daily activity (between-group difference, -22.9 [95%CI, -28.3 to -17.4]; P < 0.01) than the control group. Similarly, the intervention group had better improvements in AKPS (between-group difference, 9.0 [95%CI, 4.1 to 13.9]; P < 0.01) and knee extensor strength (between-group difference, 20.1 [95%CI, 14.5 to 25.8]; P < 0.01), compared to the control group. No adverse events were reported.
CONCLUSION
Home-based exercise and health education resulted in less pain, better function, and higher knee muscle strength compared with no exercise in patients with PFP. A large randomized controlled trial with long-term follow-up is required to confirm these findings.
TRIAL REGISTRATION
Chinese Clinical Trial Registry, ChiCTR2200056224 ( https://www.chictr.org.cn/showproj.aspx?proj=135506 ). Registered on February 1, 2022.
背景
髌股疼痛（PFP）是膝关节最常见的疾病之一。家庭为基础的运动是一种有效的干预措施，可以实现慢性病的自我管理。本研究评估了家庭为基础的运动和健康教育对 PFP 患者的影响。
方法
患有 PFP 的患者被随机分配到干预组（IG）或对照组（CG）。IG 组患者接受 6 周的个性化家庭运动计划，并通过远程支持进行健康教育，而 CG 组仅接受健康教育。使用前膝痛量表（AKPS）测量功能，视觉模拟量表（VAS）测量“最痛”和“日常活动时疼痛”，比较临床结果。使用等速系统测量膝关节肌肉的峰值扭矩来测量肌肉力量。
结果
在总共筛选出的 112 名符合条件的患者中，有 38 名被随机分配并进行了分析，其中干预组 19 名，对照组 19 名。两组患者在基线特征方面无显著差异。在 6 周随访时，与对照组相比，干预组的最痛减轻程度更大（组间差异，-19.3 [95%CI，-23.2 至-15.5]；P<0.01）和日常活动时疼痛减轻程度更大（组间差异，-22.9 [95%CI，-28.3 至-17.4]；P<0.01）。同样，与对照组相比，干预组在 AKPS（组间差异，9.0 [95%CI，4.1 至 13.9]；P<0.01）和膝关节伸肌力量（组间差异，20.1 [95%CI，14.5 至 25.8]；P<0.01）方面也有更好的改善。与对照组相比，干预组没有出现不良反应。
结论
与不运动相比，家庭为基础的运动和健康教育可使 PFP 患者疼痛减轻、功能改善、膝关节肌肉力量增强。需要进行更大规模的随机对照试验，并进行长期随访，以确认这些发现。
试验注册
中国临床试验注册中心，ChiCTR2200056224（https://www.chictr.org.cn/showproj.aspx?proj=135506）。注册于 2022 年 2 月 1 日。
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