Mochizuki Takeshi, Yano Koichiro, Ikari Katsunori, Okazaki Ken
Department of Orthopaedic Surgery, Kamagaya General Hospital, Kamagaya, Japan.
Department of Orthopaedic Surgery, Tokyo Women's Medical University, Tokyo, Japan.
Prog Rehabil Med. 2024 Jun 18;9:20240022. doi: 10.2490/prm.20240022. eCollection 2024.
This study aimed to evaluate the effects of locomotion training on bone mineral density (BMD) and the factors associated with increased BMD in patients with rheumatoid arthritis (RA).
We enrolled 85 patients with RA who underwent locomotion training for 6 months after receiving instructions from a physical therapist. We evaluated the BMD of the lumbar spine, total hip, and femoral neck 1 year before baseline (the start of locomotion training) and 1 year after baseline.
The change in BMD from 1 year before baseline (non-exercise period) and 1 year after baseline (exercise period) were 0.1 ± 3.1% and 1.6 ± 3.7% (P=0.007) for the lumbar spine, -0.2 ± 2.4% and 1.0 ± 2.4% (P=0.005) for the total hip, and -0.6 ± 3.9% and 1.8 ± 3.5% (P<0.001) for the femoral neck, respectively. The Health Assessment Questionnaire Disability Index score at baseline was associated with increased BMD at the femoral neck. No factor was associated with increased BMD in the lumbar spine or total hip.
Locomotion training increased the BMD of the lumbar spine, total hip, and femoral neck during the exercise period compared with that during the non-exercise period. The current treatment for RA and osteoporosis accompanied by optional therapy with locomotion training might be effective in increasing BMD in patients with RA.
本研究旨在评估运动训练对类风湿关节炎（RA）患者骨密度（BMD）的影响以及与BMD增加相关的因素。
我们纳入了85例RA患者，这些患者在接受物理治疗师的指导后进行了6个月的运动训练。我们在基线（运动训练开始）前1年和基线后1年评估了腰椎、全髋和股骨颈的BMD。
腰椎BMD从基线前1年（非运动期）到基线后1年（运动期）的变化分别为0.1±3.1%和1.6±3.7%（P=0.007），全髋为-0.2±2.4%和1.0±2.4%（P=0.005），股骨颈为-0.6±3.9%和1.8±3.5%（P<0.001）。基线时的健康评估问卷残疾指数评分与股骨颈BMD增加相关。没有因素与腰椎或全髋BMD增加相关。
与非运动期相比，运动训练在运动期增加了腰椎、全髋和股骨颈的BMD。目前针对RA和骨质疏松症的治疗并辅以运动训练的选择性疗法可能对增加RA患者的BMD有效。
