Couldrick Jacqui M, Woodward Andrew P, Lynch Joseph T, Brown Nicholas A T, Barton Christian J, Scarvell Jennie M
Faculty of Health, University of Canberra, Canberra, Australia.
Faculty of Health, University of Canberra, Canberra, Australia.
Musculoskelet Sci Pract. 2025 Jun;77:103307. doi: 10.1016/j.msksp.2025.103307. Epub 2025 Mar 5.
Clinicians may presume people with higher bodyweight or greater OA severity do not respond to exercise therapy for knee osteoarthritis (OA), but few studies have examined this.
To examine the relationship between radiographical OA severity or bodyweight and pain and functional outcomes following a structured education and exercise therapy program (Good Life with OsteoArthritis from Denmark: GLA:D®).
33 participants with knee OA were assessed at baseline and week 8 following GLA:D®. Outcomes were pain (Visual analogue scale (VAS) 0-100), Knee Injury and Osteoarthritis Outcome Score-12 (KOOS-12 total), 40 m-fast-paced walk and 30-s chair stand. Multilevel models were used to define the severity of OA in medial, lateral and patellofemoral compartments using the Kellgren-Lawrence (KL) system and to examine the relationship between compartment severity, bodyweight and outcomes.
No meaningful relationships between bodyweight and response to GLA:D® were found for any outcome measures. Greater medial OA compartment severity was related to less improvement in pain, KOOS-12 and chair stand repetitions. However, all levels of lateral compartment severity had similar improvements, and greater patellofemoral compartment severity was related to more improvement for KOOS-12 and pain.
Bodyweight may have little influence on a person's response to a structured education and exercise therapy program. While people with greater medial compartment severity were less likely to improve following the program, OA severity in the PF and lateral compartments was not a barrier to improvement.
临床医生可能认为体重较高或骨关节炎（OA）病情较重的人对膝关节骨关节炎的运动疗法无反应，但很少有研究对此进行过考察。
研究在一项结构化教育与运动疗法项目（丹麦骨关节炎美好生活项目：GLA:D®）之后，影像学OA严重程度或体重与疼痛及功能结局之间的关系。
对33名膝关节OA患者在基线时以及接受GLA:D®治疗8周后进行评估。结局指标包括疼痛（视觉模拟量表（VAS）0 - 100）、膝关节损伤和骨关节炎结局评分 - 12（KOOS - 12总分）、40米快步行走和30秒椅子站立试验。采用多水平模型，使用凯尔格伦 - 劳伦斯（KL）系统定义内侧、外侧和髌股关节腔OA的严重程度，并研究关节腔严重程度、体重与结局之间的关系。
在任何结局指标中，均未发现体重与对GLA:D®的反应之间存在有意义的关系。内侧OA关节腔严重程度越高，疼痛、KOOS - 12评分及椅子站立重复次数的改善程度越低。然而，外侧关节腔不同严重程度水平的改善情况相似，髌股关节腔严重程度越高，KOOS - 12评分及疼痛的改善程度越大。
体重对个体对结构化教育与运动疗法项目的反应可能影响甚微。虽然内侧关节腔严重程度较高的人在该项目后改善的可能性较小，但髌股关节腔和外侧关节腔的OA严重程度并非改善的障碍。
