[1]倪广晓,韩晓勇,周鸿斌,等.渐进式抗阻训练治疗女性膝关节骨关节炎的效果研究[J].中华老年骨科与康复电子杂志,2018,(03):168-174.[doi:10.3877/cma.j.issn.2096-0263.2018.03.009]
　Ni Guangxiao,Han Xiaoyong,Zhou Hongbin,et al.The effect of progressive resistance exercise program on female knee osteoarthritis[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2018,(03):168-174.[doi:10.3877/cma.j.issn.2096-0263.2018.03.009]
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渐进式抗阻训练治疗女性膝关节骨关节炎的效果研究()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2018年03期
页码:
168-174
栏目:
膝关节
出版日期:
2018-05-23

文章信息/Info

Title:
The effect of progressive resistance exercise program on female knee osteoarthritis
作者:
倪广晓; 韩晓勇; 周鸿斌; 罗志飞; 岳崴; 牛彦平
050000 石家庄，河北医科大学第二医院康复科
Author(s):
Ni Guangxiao;  Han Xiaoyong;  Zhou Hongbin;  Luo Zhifei;  Yue Wei;  Niu Yanping
Department of Rehabilitation, The second hospital of HeBei Medical university, Shi Jiazhuang 050000, China
关键词:
骨关节炎; 膝;  疼痛;  生活质量;  渐进式抗阻训练
Keywords:
Osteoarthritis;  knee;  Pain;  Quality of life;  Progressive resistance exercise
DOI:
10.3877/cma.j.issn.2096-0263.2018.03.009
文献标志码:
A
摘要:
目的 探讨渐进式抗阻训练（PRE）对女性膝关节骨关节炎（KOA）患者膝关节功能的影响。方法 前瞻性收集2013年8月至2014年9月在河北医科大学第二医院康复科及骨科就诊的女性KOA患者92例，年龄40～70岁，平均（55±11）岁。随机分为试验组和对照组，各46例，试验组给予渐进式抗阻训练（PRE）和膝关节松动术，对照组给予膝关节松动术。由一位未参与本项目的康复师在初诊、治疗后6 w及12 w时对所有患者进行评定，评定内容包括骨性关节炎指数评分表（WOMAC）、健康调查简表（SF-36）。治疗结束后应用李科特5级量表进行患者满意度调查。结果 试验组44例患者获得随访，对照组45例患者获得随访，随访率96.7%，随访时间均为12 w。两组术后6 w和12 w VAS评分比较，试验组优于对照组[试验组：6 w：（6.0±1.8）分，12 w：（4.4±3.0）分；对照组：6 w：（7.0±1.5）分，12 w：（6.5±2.5）分]，差异有统计学意义（6 w：t=-2.573，P=0.022，12 w：t=-2.721，P=0.001）；两组术后6 w和12 w WOMAC评分结果比较，试验组优于对照组[试验组：6 w：（40±14）分，12 w：（31±14）分；对照组：6 w：（24±17）分，12 w：（38±13）分]，差异有统计学意义（6 w：t=0.001，P=0.017，12 w：t=-4.263，P=0.001）；两组12 w SF-36健康调查简表评定结果比较，试验组在生理功能和生理职能方面优于对照组，差异有统计学意义[生理功能：试验组：（50±22）分，对照组：（32±17）分，t=-3.601，P＜0.001；生理职能：试验组：（48±40）分，对照组：（22±17）分，t=-2.093，P=0.001]。两组12 w 1 RM比较，试验组优于对照组[试验组：伸膝：（11.1±4.9）RM，屈膝：（8.6±2.7）RM；对照组：伸膝：（6.9±4.2）RM，屈膝：（6.3±2.4）RM]，差异有统计学意义（伸膝：t=-2.571，P=0.001；屈膝：t=-4.882，P＜0.001）。治疗结束后试验组患者满意度明显高于对照组，差异有统计学意义（c2=17.997，P＜0.05）。结论 渐进式抗阻训练相对于传统康复训练，更有助于改善女性KOA患者的关节功能和稳定性，同时减轻关节疼痛，提高生活质量。
Abstract:
Objective To discuss the effect of progressive resistance exercise (PRE) program on female knee osteoarthritis (KOA). Methods A prospective study including 92 female KOA patients was performed in the second hospital of HeBei Medical university from August 2013 to September 2014, the average age was (55±11) years (rang from 40-70 years). All subjects were randomly divided into the experimental group (46 cases) and control group (46 cases). Subjects in experimental group participated PRE program and joint mobilization triple once a week. Subjects in the control group only participated joint mobilization. Assessments of pain, muscle strength, walking distance, function and quality of life were performed at baseline, 6 weeks and 12 weeks after surgery by a blinded assessor with The Western Ontario and McMaster Universities Osteoarthritis Index and the MOS item short from health survey (SF-36). After finishing the treatment, Satisfaction survey was conducted in all patients using Likert Scale. Results Both groups have one case dropped out, completed ratio of 12 months of follow-up was 96.7%. At 6 weeks and 12 weeks after surgery, VAS scores in experimental group were lower than control group [experimental group: 6 w: (6.0±1.8) scores, 12 w: (4.4±3.0) scores; control group: 6 w: (7.0±1.5) scores, 12 w: (6.5±2.5) scores]. Differences of VAS score between two groups had statistical significance (6 w: t=-2.573, P=0.022, 12 w: t=-2.721, P=0.001). WOMAC indexes in experimental group were higher than the control group [experimental group: 6 w: (40±14) scores, 12 w: (31±14) scores; control group: 6 w: (24±17) scores, 12 w: (38±13) scores], differences of WOMAC score between two groups had statistically significance (6 w: t=0.001, P=0.017, 12 w: t=-4.263, P=0.001). At 12 weeks postoperatively, the SF-36 scores of physical function and physical role limitation in the experimental group were higher than control group [experimental group: physical function: (50±22) scores, physical role limitation: (48±40) scores; control group: physical function: (32±17) scores, physical role limitation: (17±23) scores], differences of SF-36 score between two groups had statistically significance (physical function: t=-3.601, P<0.001, physical role limitation: t=-2.093, P=0.001). At 12 weeks postoperatively, the experimental group had better muscle strength than the control group [the experimental group: extensor: (11.1±4.9) RM, flexor: (8.6±2.7) RM; the control group: extensor: (6.9±4.2) RM, flexor: (6.3±2.4) RM], differences of 1 RM between two groups had statistically significance (extensor: t=-2.571, P=0.001, flexor: t=-4.882, P<0.001). The ratio of patient satisfaction of the experimental grup was significantly higher than the control group (c2=17.997, P<0.05). Conclusion The PRE program was effective in reducing pain, improving function and stability of keen among female patients with KOA, our study demonstrate it is better than the traditional rehabilitation trainings.

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备注/Memo

备注/Memo:
基金项目：河北医科大学第二医院科研基金（ 20161032）
更新日期/Last Update: 2018-05-22