变速变负荷运动训练联合玻璃酸钠治疗膝关节骨性关节炎的临床研究

目的： 观察变速变负荷运动训练联合玻璃酸钠治疗对膝关节骨性关节炎患者康复疗效的影响。方法：将90例膝关节骨性关节炎患者随机分成实验组、理疗组和对照组,实验组给予膝关节玻璃酸钠注射治疗和变速变负荷运动训练,理疗组给予石蜡疗法、脉冲磁场药物离子导入仪及高频电微波治疗,对照组仅给予膝关节玻璃酸钠注射治疗。结果：治疗5周后,用目测类比评分法、Lysholm膝关节功能量表和变速变负荷运动训练下肢肌力评定训练系统进行评定,三组患者膝关节疼痛、膝关节功能和股四头肌和股二头肌峰力矩均有改善（P＜0.05）,理疗组和对照组     

超短波加运动疗法治疗膝关节骨性关节炎

目的探讨超短波加运动疗法治疗膝关节骨性关节炎的效果。方法选择2013年1月至2015年1月经放射学检查符合诊断标准的膝关节骨性关节炎患者126例,依据康复方案分为观察组65例和对照组61例。观察组行超短波运动康复治疗,对照组行运动康复治疗,比较两组疗效。结果治疗后观察组膝关节功能评分[(83.4±8.9)分]明显优于对照组[(70.1±7.9)分],差异有统计学意义(P<0.05)。观察组总有效率(86.15%,56/65)优于对照组(68.85%,42/61),差异有统计学意义(P<0.05)。结论超短波运动康复疗法对膝关节骨性关节炎运动功能改善显著,值得临床推广应用。     

五合疗法配合护理干预治疗老年膝关节骨性关节炎的效果观察

[目的]观察五合疗法配合护理行为干预治疗老年膝关节骨性关节炎的效果。[方法]将120例膝关节骨性关节炎病人随机分为治疗组和对照组,治疗组采用五合疗法配合护理行为干预,对照组单纯采用五合疗法及常规护理,观察两组临床疗效及膝关节功能恢复情况。[结果]治疗组总有效率达96.67%,明显优于对照组(88.33%,P<0.05);两组膝关节功能均明显改善。[结论]五合疗法配合股四头肌肌力训练、有氧训练及行为干预,可有效地促进膝骨性关节炎病人的关节功能恢复,提高临床疗效。     

针刺联合中药熏蒸应用于膝关节骨性关节炎的效果观察

目的观察针刺联合中药熏蒸对膝关节骨性关节炎的应用效果。方法将80例患者根据入院日期的单双号分成对照组和观察组各40例,对照组运用针刺疗法,观察组在针刺疗法基础上进行中药熏蒸,比较两组膝关节功能和疼痛程度。结果治疗后观察组膝关节功能评分高于对照组,视觉模拟评分法评分低于对照组,差异有统计学意义(P<0.05)。结论针刺联合中药熏蒸能减轻膝关节骨性关节炎患者的膝关节疼痛,改善膝关节功能。     

运动训练结合玻璃酸钠治疗膝关节骨性关节炎患者关节功能改善分析

目的：评价膝关节功能训练联合玻璃酸钠注射液（施沛特）对膝关节骨性关节炎患者关节功能改善的状况。方法：选择92例膝关节骨性关节炎患者,随机分为2组,一组接受玻璃酸钠注射液膝关节内注射治疗,每周1次,连续5次为1疗程。另一组同样完成1疗程的玻璃酸钠注射液膝关节内注射治疗,但在完成第2次玻璃酸钠注射液关节内注射时开始膝关节功能训练,功能训练持续6个月,评价两组患者膝关节功能改善的差异。结果：膝关节内注射玻璃酸钠注射液联合膝关节功能训练组在改善膝关节功能方面优于单纯膝关节内注射玻璃酸钠注射液组。结论：膝关节内注射玻璃酸钠注射液联合膝关节功能训练能够对膝关节骨性关节炎起到温和持久的关节功能改善作用。     

单纯手法推拿与推拿结合运动疗法治疗膝骨性关节炎的疗效对比

目的观察单纯手法推拿与推拿结合运动疗法治疗膝骨性关节炎的疗效对比。方法 112例膝关节骨性关节炎患者随机分为两组各56例,均给予手法推拿治疗。治疗组患者在手法推拿的基础上增加膝关节等长收缩训练等运动疗法。结果全部病例治疗1个疗程,随访12个月,两组疗效比较,治疗组有效率89.3%;对照组有效率53.6%,两组总有效率相比差异有统计学意义(P0.05)。结论膝骨关节炎患者在手法推拿治疗中增加运动疗法能明显提高临床治疗效果,促进膝关节功能恢复。     

透明质酸钠并运动疗法治疗膝关节骨性关节炎的疗效观察

目的：观察透明质酸钠并运动疗法对膝关节骨性关节炎的治疗效果。方法：门诊60例膝关节骨性关节炎患者，进行关节腔内注射透明质酸钠2ml／次，3—5次为1个疗程，同时配合运动疗法。观察治疗前后Lysholm膝关节综合评分情况。结果：治疗后膝关节疼痛等症状明显改善，Lysholm膝关节综合评分明显提高（P〈0．01），有效率为86．67％，无任何不良反应发生。结论：透明质酸钠并运动疗法治疗膝关节骨性关节炎能够改善患者关节功能，提高生存质量，防止病情发展，是一种有效安全的治疗方法：     

温泉浴疗法对膝关节骨性关节炎疗效分析

目的探讨温泉浴疗法对缓解膝关节骨性关节炎的疼痛症状及改善膝关节运动功能的效果。方法选择病情稳定的膝关节骨性关节炎患者136例,进行1月的温泉浴疗法。结果疗程结束后患者的膝关节疼痛症状明显缓解,膝关节运动功能得到显著改善,总有效率94.12%。结论温泉浴是一项有效的有氧运动,1疗程结束后,能改善症状,缓解疼痛,恢复膝关节的功能,从而提高生活质量。     

高频电联合运动训练治疗膝关节骨性关节炎疗效观察

目的 观察运动训练联合物理治疗对膝关节骨性关节炎的疗效.方法 将85例膝关节骨性关节炎患者随机分为高频电组(20例,31膝)、运动训练组(33例,45膝)和运动训练联合高频电组(30例,40膝),于治疗前后采用视觉模拟评分法(VAS)和Lysholm膝关节评分量表(LKSS)对所有患者进行膝关节功能评分.结果 各组治疗前后自身对照膝关节功能得到改善,治疗后各组间比较差异有非常显著性意义( P<0.01).结论 三种治疗方法对膝关节骨性关节炎均有不同程度的疗效,高频电治疗对膝关节肿胀效果较好,运动训练起效较慢,但作用持久,两者联合治疗效果肯定.     

五合疗法配合护理干预治疗老年膝关节骨性关节炎的效果观察

[目的]观察五合疗法配合护理行为干预治疗老年膝关节骨性关节炎的效果。[方法]将120例膝关节骨性关节炎病人随机分为治疗组和对照组,治疗组采用五合疗法配合护理行为干预,对照组单纯采用五合疗法及常规护理,观察两组临床疗效及膝关节功能恢复情况。[结果]治疗组总有效率达96．67％,明显优于对照组（88．33％,P〈0．05）;两组膝关节功能均明显改善。[结论]五合疗法配合股四头肌肌力韧I练、有氧训练及行为干预,可有效地促进膝骨性关节炎病人的关节功能恢复,提高临床疗效。     

The effect of dynamic versus isometric resistance training on pain and functioning among adults with osteoarthritis of the knee

OBJECTIVE: To compare 16 weeks of isometric versus dynamic resistance training versus a control on knee pain and functioning among patients with knee osteoarthritis (OA). DESIGN: Randomized clinical trial. SETTING: Outpatient setting. PARTICIPANTS: A total of 102 volunteer subjects with OA of the knee randomized to isometric (n=32) and dynamic (n=35) resistance training groups or a control (n=35). INTERVENTIONS: Strength exercises for the legs, 3 times weekly for 16 weeks. Dynamic group: exercises across a functional range of motion; isometric: exercises at discrete joint angles. MAIN OUTCOME MEASURES: The time to descend and ascend a flight of 27 stairs and to get down and up off of the floor. Knee pain was assessed immediately after each functional task. The Western Ontario and McMaster Universities Osteoarthritis Index was used to assess perceived pain, stiffness, and functional ability. RESULTS: In the isometric group, time to perform all 4 functional tasks decreased (P<.05) by 16% to 23%. In the dynamic group, time to descend and ascend stairs decreased by 13% to 17%. Both groups decreased knee pain while performing the functional tasks by 28% to 58%. Other measures of pain and functioning were significantly and favorably affected in the training groups. The improvements in the 2 training groups as a result of their respective therapies were not significantly different. The control group did not change over the duration of the study. CONCLUSION: Dynamic or isometric resistance training improves functional ability and reduces knee joint pain of patients with knee OA.     

运动疗法对膝骨关节炎的疗效观察

目的探讨运动疗法对膝骨关节炎治疗效果的影响。方法 40例膝骨关节炎患者分为对照组(n=20)和治疗组(n=20),对照组采用常规理疗、针灸、熏洗、按摩等治疗,治疗组在常规治疗基础上加入运动疗法,包括肌力训练、关节活动度训练。治疗前后采用Lysholm膝关节评分量表和视觉模拟评分法(VAS)进行评定。结果两组患者VAS和Lysholm膝关节量表评分均改善,治疗组较对照组改善更明显(P<0.01)。结论运用运动疗法能进一步改善膝骨关节炎患者膝关节功能,缓解疼痛。     

Functional performance and inflammatory cytokines after squat exercises and whole-body vibration in elderly individuals with knee osteoarthritis

Simão AP, Avelar NC, Tossige-Gomes R, Neves CD, Mendonça VA, Miranda AS, Teixeira MM, Teixeira AL, Andrade AP, Coimbra CC, Lacerda AC. Functional performance and inflammatory cytokines after squat exercises and whole-body vibration in elderly individuals with knee osteoarthritis.ObjectiveTo investigate the effects of squat exercises combined with whole-body vibration on the plasma concentration of inflammatory markers and the functional performance of elderly individuals with knee osteoarthritis (OA).DesignClinical, prospective, randomized, single-blinded study.SettingExercise physiology laboratory.ParticipantsElderly subjects with knee OA (N=32) were divided into 3 groups: (1) squat exercises on a vibratory platform (platform group, n=11); (2) squat exercises without vibration (squat group, n=10); and (3) the control group (n=11).InterventionsThe structured program of squat exercises in the platform and squat groups was conducted 3 times per week, on alternate days, for 12 weeks.Main Outcome MeasuresPlasma soluble tumor necrosis factor-α receptors 1 (sTNFR1) and 2 (sTNFR2) were measured using immunoassays (the enzyme-linked immunosorbent assay method). The Western Ontario and McMaster Universities Osteoarthritis Index questionnaire was used to evaluate self-reported physical function, pain, and stiffness. The 6-minute walk test, the Berg Balance Scale, and gait speed were used to evaluate physical function.ResultsIn the platform group, there were significant reductions in the plasma concentrations of the inflammatory markers sTNFR1 and sTNFR2 (P<.001 and P<.05, respectively) and self-reported pain (P<.05) compared with the control group, and there was an increase in balance (P<.05) and speed and distance walked (P<.05 and P<.001, respectively). In addition, the platform group walked faster than the squat group (P<.01).ConclusionsThe results suggest that whole-body vibration training improves self-perception of pain, balance, gait quality, and inflammatory markers in elderly subjects with knee OA.     

前交叉韧带重建术后患者的等速肌力训练和疗效评定

目的:研究用Biodex system 3多关节等速肌力评定及训练系统对ACL重建术后患者肌力的影响。方法:将50例行ACL重建术后的患者随机分成试验组25例(等速训练患侧肌力)和对照组25例(等张训练患侧肌力)并分别进行功能训练,在术后第12、24周进行等速向心肌力测试。结果:术后第12、24周对患者进行膝关节等速向心肌力测试,试验组膝屈、伸肌患侧峰力矩/健侧峰力矩比值明显高于对照组,差异具有显著性(P<0.05),试验组在30°时的股内侧肌患侧峰力矩/健侧峰力矩比值明显高于对照组,差异具有显著性(P<0.05)。结论:通过等速训练进行系统的康复治疗可使膝关节ACL重建术后的患者短期(6个月)达到健侧屈伸肌力水平,并能达到运动水平。     

Effects of combined application of progressive resistance training and Russian electrical stimulation on quadriceps femoris muscle strength in elderly women with knee osteoarthritis

[Purpose] The aim of this study was to investigate the effects of combined application of progressive resistance training and Russian electrical stimulation on quadriceps femoris muscle strength in elderly women with osteoarthritis of the knee. [Subjects] Thirty women over 65 years of age diagnosed with knee osteoarthritis participated in the present study. The subjects were randomly assigned to a control group (n=10), a progressive resistance training group (n=10), or a Russian electrical stimulation group (n=10). [Methods] Each group was treated 3 times weekly for 8 weeks, and each session lasted 45 minutes. Muscle strength was assessed by measuring the peak torque of the quadriceps femoris muscle. Outcome measurements were performed at baseline and at the fourth and eighth weeks of the treatment period. [Results] All groups showed significant intragroup differences in the quadriceps femoris muscle peak torque after the treatment intervention. There were significant intergroup differences between the Russian electrical stimulation group and the other groups. [Conclusion] The results of this study suggest that combined application of progressive resistance training and Russian electrical stimulation can be effective in strengthening the quadriceps femoris muscle in elderly women with knee osteoarthritis.Key words: Knee osteoarthritis, Progressive resistance training, Russian electrical stimulation     

核心稳定性锻炼对膝骨关节炎的临床效果观察

目的：探讨核心稳定性锻炼对膝骨关节炎的治疗效果。方法选择膝骨关节炎患者60例,应用计算机随机分为两组,对照组30例采用常规理疗、针灸、熏洗、按摩等治疗,治疗组在常规治疗基础上加入核心稳定性锻炼。治疗前后采用 Lysholm 膝关节评分量表和视觉模拟评分法（VAS）进行评定。结果治疗组治疗前后 VAS 分别为（8.31±1.16）、（3.37±0.97）分,差异有统计学意义（t =16.30,P=0.00）;对照组治疗前后 VAS 分别为（8.26±1.22）、（5.06±0.82）分,差异有统计学意义（t =12.19,P=0.00）;两组治疗后比较差异有统计学意义（t =-6.98,P =0.00）。治疗组治疗前后 Lysholm 膝关节量表评分分别为（32.92±4.21）、（60.19±4.42）分,差异有统计学意义（t =-30.44,P =0.00）;对照组治疗前后 Lysholm 膝关节量表评分分别为（34.82±5.58）、（53.49±3.66）分,差异有统计学意义（t =-14.82,P =0.00）;两组治疗后比较差异有统计学意义（t =7.16,P =0.00）。结论核心稳定性锻炼能进一步改善膝骨关节炎患者膝关节功能,缓解疼痛。     

Effects of the MWM Technique Accompanied by Trunk Stabilization Exercises on Pain and Physical Dysfunctions Caused by Degenerative Osteoarthritis

[Purpose] This study aimed to identify how treatment with the Mulligan technique of mobilization with movement (MWM) influences pain and physical function of patients with degenerative osteoarthritis. [Subjects] Thirty patients diagnosed with degenerative osteoarthritis were divided into an experimental group (n=15), and a control group (n=15). [Methods] The experimental group was treated with general physical therapy, trunk stabilization exercises, and performed the MWM using the Mulligan technique. The control group was treated with general physical therapy, and then performed trunk stabilization exercises. [Results] Statistically significant differences were found after the intervention in the experimental group in the visual analog scale and Western Ontario and McMaster Universities osteoarthritis index pain, stiffening, and physical function scores. [Conclusion] We consider the treatment of degenerative osteoarthritis patients using the MWM technique is effective for reducing pain and improving physical functions.Key words: Osteoarthritis, MWM, Knee     

Effects of isometric exercise using biofeedback on maximum voluntary isometric contraction,pain, and muscle thickness in patients with knee osteoarthritis

[Purpose] The purpose of our study was to investigate the effects of isometric exercises using electromyographic biofeedback (EMGBF) and ultrasound biofeedback (USBF) on maximum voluntary isometric contraction (MVIC), pain assessed by the Visual Analogue Scale (VAS), and vastus medialis oblique (VMO) thickness in patients with knee osteoarthritis (OA). [Subjects and Methods] Thirty females over 65 years of age who had been diagnosed with knee osteoarthritis were recruited and randomly assigned to three groups, each comprising of 10 subjects. The Subjects in the EMGBF training and USBF training groups were trained with the corresponding physical training exercise program targeting the vastus medialis oblique, whereas the subjects in the control group were treated with conventional physical therapies, such as a hot pack, ultrasound, and transcutaneous electrical nerve stimulation. Subjects in each group were trained or treated for 20 min, 3 times a week for 8 weeks. [Results] The MVIC in the EMGBF and USBF training groups was significantly increased compared with that in the control group, and the VAS score (for measurement of pain) in the EMGBF and USBF training groups was significantly decreased compared with that in the control group. Only the EMGBF training group showed a significantly increased VMO thickness compared with before training. [Conclusion] These results suggest that USBF training is similar to EMGBF training in terms of its effectiveness and is helpful for treating patients with knee OA.Key words: Conventional physical therapy, Electromyographic biofeedback, Ultrasound biofeedback     

Effect of proprioceptive training on foot posture,lower limb alignment,and knee adduction moment in patients with degenerative knee osteoarthritis: a randomized controlled trial

[Purpose] The purpose of this study was to determine the effect of proprioceptive training on foot progression angle, weight-bearing ratio, and knee adduction moment in patients with degenerative osteoarthritis of the knee. [Subjects] The subjects were 37 patients diagnosed with Kellgren-Lawrence grade 2 or 3 degenerative knee osteoarthritis. They were randomly allocated to three groups: a proprioceptive training group (PT group), quadriceps strengthening group (QS group), and control group. [Methods] The study parameters of the three groups were compared before and after a 12-week training period. Therapeutic exercises were performed twice per week for 12 weeks. Outcomes included the foot progression angle, weight-bearing ratio, and knee adduction moment. [Results] First, a significant difference in the foot progression angle was observed among the groups, significantly increasing in the PTG compared with the CG. Second, a significant difference in the weight-bearing ratio was observed among the groups, significantly increasing in the PTG compared with the CG. Third, a significant difference in the first peak knee adduction moment was observed among the groups, significantly decreasing in the PTG compared with the CG. [Conclusion] The results of the present study indicate that proprioceptive training increased the foot progression angle and weight-bearing ratio and decreased the first peak knee adduction moment. Moreover, incorporating proprioceptive training into a physical therapy exercise program could improve functional ability and delay the progression of degenerative osteoarthritis.Key words: Knee osteoarthritis, Knee adduction moment, Proprioceptive training     

Quadriceps-strengthening exercise and quadriceps and knee biomechanics during walking in knee osteoarthritis: A two-centre randomized controlled trial

ObjectiveTo assess the effect of quadriceps strengthening on quadriceps muscle force, power, and work and tibio-femoral compressive loads during walking in adults with knee osteoarthritis.MethodsStudy design: Two-center, randomized, controlled trial. Intervention: Patients with knee osteoarthritis were randomly allocated to quadriceps strengthening program (3 times weekly) or no attention control group. Main outcome measures: Primary outcome was change from baseline in peak quadriceps force during walking at 12 weeks. Secondary outcomes included quadriceps power and work, knee compression forces during walking estimated with musculoskeletal modeling, muscle strength and pain and function. Outcomes were measured at baseline and 12 weeks.Results30 patients were randomized to receive either training (n = 15) or no attention (n = 15). At follow-up, there were no statistical differences between groups for maximum quadriceps force, quadriceps positive power, negative work, and positive work, and knee compressive force. Maximum negative quadriceps power in early stance was statistically significantly increased 36% in the training group compared to the control group which was most likely partially a response to faster walking velocity at follow-up. Muscle strength and patient reported pain and function were improved in the training group compared to the control group.ConclusionsQuadriceps strength training leads to increased muscle strength and improved symptomatic and functional outcomes but does not change quadriceps or knee joint biomechanics during walking. The biomechanical mechanism of improved health with strength training in knee osteoarthritis patients remains unknown.ClinicalTrials.gov Identifier: NCT01538407.