基于诊所和异步视频的运动对膝骨关节炎患者临床及心理社会结局的影响：准实验研究

Effect of Clinic-Based and Asynchronous Video-Based Exercise on Clinic and Psychosocial Outcomes in Patients With Knee Osteoarthritis: Quasi-Experimental Study.

作者信息

Mbada Chidozie E, Awosika Henry Akintunji, Sonuga Oluwatobi Ademola, Akande Micheal, Gebrye Tadesse, Woolf Richard, Fatoye Francis

机构信息

Department of Health Professions, Faculty of Health and Education, Manchester Metropolitan University, Manchester, United Kingdom.

Department Of Medical Rehabilitation, College Of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.

出版信息

J Med Internet Res. 2025 Mar 26;27:e58393. doi: 10.2196/58393.

DOI:10.2196/58393

PMID:40138680

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11982774/

Abstract

BACKGROUND

Telerehabilitation is promising for improving knee osteoarthritis, but the effect of different telerehabilitation strategies on knee osteoarthritis is unclear.

OBJECTIVE

This study aimed to examine the effect of a clinic-based strengthening exercise (CbSE) and asynchronous video-based strengthening exercise (AVbSE) on pain, range of motion, muscle strength, quality of life, and physical function among patients with knee osteoarthritis.

METHODS

A total of 52 consenting patients participated in this 8-week experimental study; they were assigned to the CbSE or AVbSE group at 2 different study sites. CbSE is a circuit exercise module comprising knee flexion and extension warm-up in sitting, quadriceps isometric setting, quadriceps strengthening exercise, hamstring clenches, wall squat, and a cooldown of knee flexion and extension. The AVbSE is an asynchronous video-based version of the CbSE.

RESULTS

This study spanned from March 31, 2021, to November 26, 2021. Eight out of 62 participants discontinued participation. Data collection and analysis have been completed. Significant differences were only observed in the mental health (t=-3, P=.004), pain (t=-3.6, P<.001), social support (t=-2.7, P=.009), and social activities (t=2.2, P=.03) domains of the Osteoarthritis Knee and Hip Quality of Life (OAKHQoL) questionnaire with higher scores in the AVbSE group at the end of week 4. At the end of week 8, significant differences were observed in mental health (t=-2.1, P=.04) and pain (t=-2.8, P=.008) measures with higher scores in AVbSE; however, a significantly higher score was observed in the CbSE group for the Quadruple Visual Analog Scale. No significant main effect of time was observed in this study, except in the muscle strength (F=1.5, P=.24), social support (F=2.5, P=.09), and social activity (F=0.7, P=.48) domains of the OAKHQoL questionnaire and activity limitation (F=0.1, P=.90), and performance restriction (F=1.3, P=.27) domains of the Ibadan Knee and Hip Osteoarthritis Outcome Measure (IKHOAM) questionnaire. There was no significant difference between groups in all OAKHQoL domains except social activities (mean 17.6, SD 1.2 vs 22.8, SD 1.2; P=.003) and average pain (2.8, SD 1.6 vs 2.3, SD 1.6; P=.03) with higher AVbSE mean scores. However, a higher score was observed for the CbSE group in the Quadruple Visual Analog Scale's least pain domain (1.2, SD 0.2 vs 0.7, SD 0.2; P=.04). Also, interaction effects showed that AVbSE scores were significantly higher for the OAKHQoL questionnaire's physical activity and mental health domains at all time points. However, the CbSE score was higher for the physical performance domain of the IKHOAM questionnaire in the eighth week.

CONCLUSIONS

CbSE circuit training and its AVbSE variant effectively improve treatment outcomes and increase the quality of life of patients. While AVbSE was associated with higher improvement in most health-related quality of life domains, CbSE led to higher improvement in average pain.

TRIAL REGISTRATION

Pan African Clinical Trial Registry PACTR202208515182119, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=23943.

摘要

背景

远程康复有望改善膝关节骨关节炎，但不同的远程康复策略对膝关节骨关节炎的影响尚不清楚。

目的

本研究旨在探讨基于诊所的强化运动（CbSE）和基于异步视频的强化运动（AVbSE）对膝关节骨关节炎患者疼痛、关节活动范围、肌肉力量、生活质量和身体功能的影响。

方法

共有52名同意参与的患者参加了这项为期8周的实验研究；他们被分配到2个不同研究地点的CbSE组或AVbSE组。CbSE是一个循环运动模块，包括坐姿膝关节屈伸热身、股四头肌等长收缩、股四头肌强化运动、腘绳肌收紧、靠墙蹲坐以及膝关节屈伸放松运动。AVbSE是CbSE的基于异步视频的版本。

结果

本研究从2021年3月31日持续至2021年11月26日。62名参与者中有8人退出研究。数据收集和分析已完成。仅在第4周结束时，在膝关节和髋关节骨关节炎生活质量（OAKHQoL）问卷的心理健康（t=-3，P=.004）、疼痛（t=-3.6，P<.001）、社会支持（t=-2.7，P=.009）和社会活动（t=2.2，P=.03）领域观察到显著差异，AVbSE组得分更高。在第8周结束时，在心理健康（t=-2.1，P=.04）和疼痛（t=-2.8，P=.008）测量中观察到显著差异，AVbSE得分更高；然而，在四重视觉模拟量表中，CbSE组得分显著更高。除了在OAKHQoL问卷的肌肉力量（F=1.5，P=.24）、社会支持（F=2.5，P=.09）和社会活动（F=0.7，P=.48）领域以及伊巴丹膝关节和髋关节骨关节炎结局测量（IKHOAM）问卷的活动受限（F=0.1，P=.90）和功能受限（F=1.3，P=.27）领域外，本研究未观察到时间的显著主效应。除社会活动（平均值17.6，标准差1.2对22.8，标准差1.2；P=.003）和平均疼痛（2.8，标准差1.6对2.3，标准差1.6；P=.03）外，AVbSE组平均得分更高，在所有OAKHQoL领域中两组之间无显著差异。然而，在四重视觉模拟量表的最不痛领域中，CbSE组得分更高（1.2，标准差0.2对0.7，标准差0.2；P=.04）。此外，交互作用表明，在所有时间点，AVbSE在OAKHQoL问卷的身体活动和心理健康领域得分显著更高。然而，在第8周时，CbSE在IKHOAM问卷的身体功能领域得分更高。