脉冲电磁场疗法对终末期膝骨关节炎患者肌肉力量和疼痛的影响：一项随机对照试验。
The effects of pulsed electromagnetic field therapy on muscle strength and pain in patients with end-stage knee osteoarthritis: a randomized controlled trial.
作者信息
Wang Qian-Wen, Ong Michael Tim-Yun, Man Gene Chi-Wai, Franco-Obregón Alfredo, Choi Ben Chi-Yin, Lui Pauline Po-Yee, Fong Daniel T P, Qiu Ji-Hong, He Xin, Ng Jonathan Patrick, Yung Patrick Shu-Hang
机构信息
Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, Hong Kong SAR, China.
Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
出版信息
Front Med (Lausanne). 2024 Oct 16;11:1435277. doi: 10.3389/fmed.2024.1435277. eCollection 2024.
BACKGROUND
Osteoarthritis (OA) of the knee is one of the most common chronic degenerative joint conditions affecting aging population.
AIM
To investigate the effectiveness of a combination of home-based exercise and pulsed electromagnetic field (PEMF) therapy to improve muscle strength, physical function, and pain.
METHODS
Sixty patients were randomly assigned to either home-based exercise alone (control group; = 30) or combined with PEMF therapy (treatment group; = 30) twice a week for eight weeks. Knee extension, flexion muscle strength, gait speed (GS), 5 time sit-to-stand test (5STS), Visual Analogue Scale (VAS) pain and Knee Injury and Osteoarthritis Outcome Score (KOOS) were recorded at baseline and 4 and 8 weeks.
RESULTS
Significant improvements in symptomatic knee extension muscle strength (SKE, = 0.001), flexion strength (SKF, = 0.011), contralateral knee extension muscle strength (CKE, = 0.002), and flexion strength (CKF, = 0.009) were observed for the PEMF treatment group at 8 weeks. Significant reductions in VAS pain scores were observed in both the treatment ( < 0.001, partial η = 0.505) and control ( < 0.001, partial η = 0.268) groups. Significant differences were reported between groups in the 4 ( = 0.010, partial η = 0.111) and 8 ( = 0.046, partial η = 0.068) week assessment in VAS pain. A significant time difference was found in GS and 5STS between baseline and week 8 (GS: difference 0.051, = 0.026; 5STS: difference 2.327, < 0.001) in the treatment group. The significant group difference at week 8 was observed in SKE ( = 0.013) in female patients while pain in male patients ( = 0.026). Patients aged over 70 years have a significantly superior improvement in SKE, SKF, and CKF after 8 weeks of PEMF therapy.
CONCLUSION
The combination of PEMF therapy and home-based exercise superiorly improved knee muscle strength and reduced pain in end-stage knee OA subjects and showed a promising tendency to improve performance-based physical function. PEMF therapy was shown to preferentially benefit knee muscle strength in female patients and patients aged over 70 years, whereas male patients were more responsive to PEMF therapy in the form of pain relief.
CLINICAL TRIAL REGISTRATION
clinicalTrials.gov, NCT05550428.
背景
膝关节骨关节炎（OA）是影响老年人群的最常见慢性退行性关节疾病之一。
目的
研究家庭锻炼与脉冲电磁场（PEMF）疗法相结合对改善肌肉力量、身体功能和疼痛的有效性。
方法
60例患者被随机分为仅进行家庭锻炼的组（对照组；n = 30）或联合PEMF疗法的组（治疗组；n = 30），每周两次，共八周。在基线、4周和8周时记录膝关节伸展、屈曲肌肉力量、步态速度（GS）、5次坐立试验（5STS）、视觉模拟评分法（VAS）疼痛评分以及膝关节损伤和骨关节炎疗效评分（KOOS）。
结果
PEMF治疗组在8周时，患侧膝关节伸展肌肉力量（SKE，P = 0.001）、屈曲力量（SKF，P = 0.011）、对侧膝关节伸展肌肉力量（CKE，P = 0.002）和屈曲力量（CKF，P = 0.009）有显著改善。治疗组（P < 0.001，偏η² = 0.505）和对照组（P < 0.001，偏η² = 0.268）的VAS疼痛评分均显著降低。两组在4周（P = 0.010，偏η² = 0.111）和8周（P = 0.046，偏η² = 0.068）评估的VAS疼痛方面存在显著差异。治疗组在基线和第8周之间的GS和5STS有显著的时间差异（GS：差异0.051，P = 0.026；5STS：差异2.327，P < 0.001）。在第8周时，女性患者的SKE有显著的组间差异（P = 0.013），而男性患者的疼痛有显著差异（P = 0.026）。70岁以上的患者在接受8周PEMF治疗后，SKE、SKF和CKF有显著更好的改善。
结论
PEMF疗法与家庭锻炼相结合能显著改善终末期膝关节OA患者的膝关节肌肉力量并减轻疼痛，且在改善基于表现的身体功能方面显示出有前景的趋势。PEMF疗法在女性患者和70岁以上患者中对膝关节肌肉力量有优先益处，而男性患者对PEMF疗法在缓解疼痛方面反应更明显。
临床试验注册
clinicalTrials.gov，NCT05550428。
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