核心肌群与髋部强化训练对成人膝骨关节炎膝关节功能的影响:一项随机对照试验
Effect of Core Versus Hip Strengthening on Knee Function in Adults With Knee Osteoarthritis: A Randomized Controlled Trial.
作者信息
Jadhav Vrushali, Palsule Shilpshree
机构信息
Occupational Therapy, Occupational Therapy (OT) Training School and Centre, Seth Gordhandas Sunderdas (GS) Medical College and King Edward Memorial (KEM) Hospital, Mumbai, IND.
出版信息
Cureus. 2025 Jun 13;17(6):e85967. doi: 10.7759/cureus.85967. eCollection 2025 Jun.
Background Osteoarthritis (OA) is a prevalent condition characterized by joint pain, functional limitation, and reduced quality of life, particularly affecting older adults, with a higher prevalence in women. OA impacts daily activities, such as walking, climbing stairs, and driving, and is one of the leading causes of pain and disability worldwide. This further affects a person's ability to carry out their activities of daily living and reduces quality of life as a consequence. Exercise remains a core recommendation for managing knee osteoarthritis (OA), and structured exercise programs have been shown to improve knee-related and overall health outcomes. Existing literature supports the effectiveness of core stability and hip strengthening exercises when added to knee strengthening for the management of OA knee. However, there is limited research comparing these two approaches. This study aims to evaluate the effect of supervised core stability versus hip strengthening exercises, alongside conventional occupational therapy, on improving functional outcomes, mobility, and strength in OA knee patients. Methodology Patients diagnosed with unilateral osteoarthritis of the knee, grades 1, 2, and 3 according to the Kellgren-Lawrence( KL) grading system, managed conservatively, with no history of trauma or surgery of symptomatic knee after taking approval from the Institutional Ethics Committee of Seth GS Medical College and KEM Hospital were categorized into group A (Core) and group B (Hip) using convenient sampling. A total of 34 patients, both males and females, between 40 and 60 years of age were allocated into group A or B, and were evaluated at baseline, 2 weeks, 4 weeks, and 6 weeks on the knee osteoarthritis outcome score (KOOS), 30-second chair stand test, and the modified Oxford manual muscle grading system. Both groups were given conventional occupational therapy treatment. Results Both the Core and Hip groups showed a statistically significant improvement in KOOS, muscle strength of knee flexors and extensors, and the number of repetitions on the 30-second chair stand test. When the Core and Hip groups were compared, the improvement in these parameters was statistically insignificant. Conclusion Both hip and core strengthening exercises are equally effective in improving muscle strength, pain, quality of life, and activities of daily living, leading to improvement in KOOS scores in patients with OA knee.
背景
骨关节炎(OA)是一种常见病症,其特征为关节疼痛、功能受限和生活质量下降,尤其影响老年人,女性患病率更高。OA会影响日常活动,如行走、爬楼梯和驾驶,是全球疼痛和残疾的主要原因之一。这进而影响一个人进行日常生活活动的能力,并降低生活质量。运动仍然是管理膝关节骨关节炎(OA)的核心建议,结构化运动计划已被证明可改善与膝关节相关的健康状况和整体健康结果。现有文献支持在加强膝关节锻炼的基础上增加核心稳定性和髋关节强化锻炼对OA膝关节管理的有效性。然而,比较这两种方法的研究有限。本研究旨在评估在传统职业治疗的基础上,监督下的核心稳定性锻炼与髋关节强化锻炼对改善OA膝关节患者功能结果、活动能力和力量的效果。
方法
经诊断为单侧膝关节骨关节炎、根据凯尔格伦-劳伦斯(KL)分级系统为1、2和3级、采用保守治疗、在获得塞思GS医学院和KEM医院机构伦理委员会批准后,有症状膝关节无创伤或手术史的患者,通过方便抽样分为A组(核心组)和B组(髋关节组)。共有34名年龄在40至60岁之间的男性和女性患者被分配到A组或B组,并在基线、2周、4周和6周时进行膝关节骨关节炎结局评分(KOOS)、30秒坐立试验和改良牛津徒手肌力分级系统评估。两组均接受传统职业治疗。
结果
核心组和髋关节组在KOOS、膝关节屈伸肌肌力以及30秒坐立试验的重复次数方面均显示出统计学上的显著改善。当比较核心组和髋关节组时,这些参数的改善在统计学上无显著差异。
结论
髋关节和核心强化锻炼在改善肌肉力量、疼痛、生活质量和日常生活活动方面同样有效,可使OA膝关节患者的KOOS评分得到改善。