Qiu Jie, Zhou Tiantian, Jin Huihong, Pan Yujian, Qian Tingting, Xue Chuan, Xia Wen, Shi Haitao, An Bingchen
Department of Rehabilitation, Huadong Hospital Affiliated to Fudan University, Shanghai, China.
Qibao Community Health Service Center, Minhang District, Shanghai, China.
BMC Sports Sci Med Rehabil. 2023 Nov 23;15(1):158. doi: 10.1186/s13102-023-00772-7.
Hip adductor and abductor strength were both reduced in KOA patients. But to date, most of the researches have only focused on quadriceps combined with hip abductor strengthening versus quadriceps strengthening.
The aim of the study is to evaluate the effect of adding hip abductor and adductor strengthening to quadriceps strengthening on lower limb strength, knee pain and physical function in patients with medial compartmental knee osteoarthritis.
In this study, 42 participants, were randomly divided into two groups: the general treatment group (GT group) and the added-hip-exercise group (AH group). All participants were given a general rehabilitation treatment. The AH group performed hip abductor and adductor strengthening in addition to the general rehabilitation treatment. Knee and hip muscle strength, Five Times Sit-to-Stand Test (FTSST), the Timed Up and Go Test (TUGT), Numerical Rating Scale (NRS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were assessed at baseline and 6 weeks. A two-sided 2-sample unpaired t test was performed to compare the difference in mean change scores between AH and GT groups.
Finally, 36 participants completed the study: both groups consist of 18 participants. In the per-protocol analysis, the AH group had a greater improvement in knee extension strength (mean changes, 7.84 versus 36.48; P < 0.001) and hip abduction strength (mean changes, 5.05 versus 26.62; P = 0.001) than the control group. Similarly, the AH group had a greater improvement in the FTSST time (mean changes, 0.40 s versus 3.57 s; P < 0.001) and the TUFT time (mean changes, 0.18 s versus 1.67 s; P = 0.002) than the GH group. No statistical difference was found in the change of WOMAC pain scores and NRS between the 2 groups.
Older adults with knee OA in the AH group had superior muscle strength, symptoms and daily activity performance at the 6th week than those in the GT group. And adding hip exercises could expedite improvement of pain at the 2th week, but not at the 6th week.
Clinical trial registration numbers and date of registration: ChiCTR-IOR-16009124, Registered 30 August 2016.
膝关节骨关节炎（KOA）患者的髋内收肌和外展肌力量均有所下降。但迄今为止，大多数研究仅关注股四头肌联合髋外展肌强化训练与单纯股四头肌强化训练的对比。
本研究旨在评估在股四头肌强化训练基础上增加髋外展肌和内收肌强化训练对内侧间室膝关节骨关节炎患者下肢力量、膝关节疼痛及身体功能的影响。
本研究中，42名参与者被随机分为两组：常规治疗组（GT组）和增加髋部锻炼组（AH组）。所有参与者均接受常规康复治疗。AH组在常规康复治疗基础上进行髋外展肌和内收肌强化训练。在基线和6周时评估膝关节和髋关节肌肉力量、五次坐立试验（FTSST）、计时起立行走试验（TUGT）、数字评定量表（NRS）以及西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分。采用双侧双样本非配对t检验比较AH组和GT组平均变化分数的差异。
最终，36名参与者完成了研究：两组各有18名参与者。在符合方案分析中，AH组在膝关节伸展力量（平均变化：7.84对36.48；P＜0.001）和髋外展力量（平均变化：5.05对26.62；P = 0.001）方面比对照组有更大改善。同样，AH组在FTSST时间（平均变化：0.40秒对3.57秒；P＜0.001）和TUGT时间（平均变化：0.18秒对1.67秒；P = 0.002）方面比GT组有更大改善。两组间WOMAC疼痛评分和NRS的变化无统计学差异。
AH组的老年膝关节骨关节炎患者在第6周时的肌肉力量、症状及日常活动表现优于GT组。并且增加髋部锻炼在第2周可加快疼痛改善，但在第6周时并非如此。
临床试验注册号及注册日期：ChiCTR-IOR-16009124，2016年8月30日注册。
