康复护理干预应用于膝骨关节炎患者行膝关节功能锻炼期间的价值观察

目的在膝骨关节炎患者行膝关节功能锻炼期间进行康复护理干预,并分析其应用效果。方法选取2016年1月—2018年6月,到四川省内江市中医医院进行治疗的86例膝骨关节炎患者,将患者分为两组。对照组43例,给予常规护理干预;观察组43例,给予康复护理干预。结果观察组患者治疗后1周、3周的膝关节功能评分、疼痛评分均明显低于对照组(P0.05),且各项生活质量评分明显高于对照组(P0.05)。结论对膝骨关节炎患者进行康复护理干预,能够促进膝关节功能恢复,改善患者生活质量。     

护理干预在膝骨关节炎治疗中的应用价值

目的对膝骨关节炎患者进行护理干预治疗,探究其在临床护理上的可行性。方法抽取本院的膝骨关节炎患者98例,将其平均分组,即对照组以及观察组进行分析对比,对比两组患者在进行不同的护理后,膝骨关节的恢复程度以及患者对护理的满意程度。结果通过对比,观察组的患者在进行干预护理后,其膝骨关节的恢复明显好于对照组,满意度也高于对照组,对比有差异统计学意义(P0.05)。结论对膝骨关节炎患者进行干预护理,在临床护理上具有相当高的使用价值,可以帮助患者明显改善膝关节的受损程度,恢复膝关节的正常功能。     

康复护理在膝骨关节炎患者关节功能恢复中的效果观察

目的探讨膝骨关节炎患者经康复护理后关节功能的恢复效果。方法选择2017年6月～2018年6月治疗的200例膝骨关节炎患者,其中男性145例,女性55例,随机分为观察组与对照组,每组各100例。对照组男性75例,女性25例,采用常规的护理干扰方式;观察组男性70例,女性30例,在常规护理的基础之上加以康复护理;通过HSS膝关节功能评分系统对两组患者膝骨关节功能恢复效果进行评价。结果观察组HSS膝骨关节评分指标情况明显优于对照组,观察组优良率(90%)好于对照组(76%),两组差异具有统计学意义(P0.05)。结论康复护理下的膝骨关节患者的关节功能恢复效果显著,能够有效的缓解疼痛,提高生活质量。     

冲击波治疗膝关节骨性关节炎的单盲平行模拟对照临床研究

目的研究冲击波对膝关节骨性关节炎的治疗效果和安全性。方法将72例膝关节退行性关节炎患者分为冲击波组37例，对照组35例。以直观模拟标度尺（VAS）测量值观察治疗前后患者膝关节的临床疼痛症状改善情况，通过Lequesne指数（Lequesnealgofunctionalindex）和KSKS（KneeSocietyKneeScore）评分对治疗前后的膝关节功能进行综合评价。结果冲击波组和对照组两组问患者的完成试验人数、年龄、性别、体重、身高、患膝数、VAS评分、Lequesne指数和KSKS评分无统计学差异。治疗后1、2和3个月后，冲击波组的VAS评分和Lequesne指数明显下降，KSKS评分明显升高，与对照组相比有统计学意义（P〈0．05）。结论冲击波疗法能够有效的减轻膝关节骨性关节炎患者的疼痛，改善其功能。     

早期功能锻炼对老年全膝关节置换术后心理状态及关节功能恢复的影响

目的探讨早期功能锻炼对老年全膝关节置换术后心理状态及关节功能恢复的影响。方法 84例行全膝关节置换术的老年患者,采用随机数字表法分为观察组和对照组,各42例。对照组实施常规护理,观察组采取情志护理联合早期功能锻炼。比较两组干预前后心理状态、膝关节功能。结果观察组患者SAS、SDS评分显著低于对照组(t=10.045~13.492,P0.05);观察组HSS、Lsholm、Tenger评分均明显高于对照组(t=7.218~8.608,P0.05)。结论情志护理联合早期功能锻炼有助于改善老年全膝关节置换术后心理状态,促进膝关节功能恢复。     

老年女性膝骨关节炎患者常见危险因素调查

目的调查沈阳市区老年女性膝骨关节炎(KOA)患者常见危险因素,为临床防治提供依据。方法选择2016年1月至2018年12月在本院就诊的老年女性膝骨关节炎患者169例,对照组选择同期在我院门诊体检健康老年女性155例,两组患者均接受了“膝骨关节炎常见危险因素问卷”调查。结果老年膝骨关节炎组的平均年龄、BMI、体力劳动者、膝骨关节炎家族史、吸烟指数、膝关节外伤史、缺乏锻炼、寒冷环境例数均显著多于对照组(P<0.01,P<0.05)。结论年龄偏大、肥胖、膝骨关节炎家族史、膝关节外伤史、吸烟、寒冷环境、缺乏锻炼都是沈阳市区老年女性膝骨关节炎患者常见危险因素。     

悬吊技术联合Mulligan手法对膝骨关节炎老年人群运动后疼痛的康复效果

目的 探究悬吊技术联合Mulligan手法用于膝骨关节炎老年人运动后膝关节疼痛康复的效果.方法 选取84例单侧膝关节运动后疼痛的膝骨关节炎老年患者,依据随机数字表法分为观察组和对照组,各42例.对照组给予常规物理治疗与悬吊训练治疗,观察组在对照组基础上给予Mulligan技术治疗.比较两组治疗开始前与治疗后视觉模拟评分(VAS)疼痛评分、QOL-BREF评分、LEFS下肢功能评分、膝关节功能评分、关节活动度、四头肌与腘绳肌肌力.结果 两组治疗后VAS评分明显降低(P<0.05),且观察组VAS评分明显低于对照组(P<0.05).两组治疗后QOL-BREF评分/LEFS评分、膝关节功能评分、关节活动度、四头肌与腘绳肌肌力较治疗前明显提高(P<0.05),且治疗后观察组QOL-BREF评分/LEFS评分、膝关节功能评分、关节活动度、四头肌与腘绳肌肌力明显高于对照组(P<0.05).结论 对于膝关节运动后疼痛的膝骨关节炎老年患者,悬吊技术联合Mulligan手法,能有效缓解膝关节疼痛、促进膝关节功能恢复,提高患者生活质量.     

施氏温针灸治疗膝骨性关节炎的功能恢复及预后分析

目的探究施氏温针灸治疗对膝骨性关节炎患者功能恢复及预后的影响。方法将我院收治的109例膝骨性关节炎患者按初次就诊日期单双号分为观察组(61例)、对照组(48例)。对照组患者口服醋氯芬酸分散片,观察组患者行施氏温针灸治疗,就两组患者的膝关节功能恢复及预后情况进行比较。结果观察组的总有效率为96.72%,明显高于对照组(85.42%,P<0.05)。治疗后6周、3个月,观察组的各项WOMAC评分均明显低于对照组,观察组在治疗后3个月的50码最快步行时间明显低于对照组,速度改善率明显高于对照组,差异比较有统计学意义(P<0.05)。结论施氏温针灸治疗有助于膝骨性关节炎患者膝关节功能及预后的快速恢复。     

七味三七口服液联合持续被动运动仪对全膝置换术后膝关节功能及血液流变学的影响

目的 观察七味三七口服液联合持续被动运动仪治疗对全膝置换术后膝关节功能及血液流变学的影响.方法 将全膝关节置换术术后93例患者随机分为观察组(46例)和对照组(47例),对照组在术后常规治疗的基础上给予膝关节持续被动运动仪锻炼,治疗组在对照组的基础上给予七味三七口服液治疗,两组治疗前后评价膝关节肿胀程度、血液流变学、凝...     

关节镜与关节腔注射玻璃酸钠治疗早期膝骨关节炎疗效对比

目的探讨膝骨关节炎的关节腔内注射玻璃酸钠治疗方法与行关节镜下清理术治疗在早期膝骨关节炎的疗效评价。方法收集120例膝骨关节炎早期患者(120个膝关节),根据治疗方法分为关节腔内注射玻璃酸钠(腔内注射组)及关节镜下清理术(清除术组),使用膝关节功能评分(HSS)评价腔内注射组注射前、注射1个疗程(5 w)后;清除术组入院时及术后5 w时膝关节功能,将收集数据进行组内及组间对比,并用统计学分析;统计腔内注射组、清除术组6~12个月复发率,将两组复发率使用统计学分析。结果两组患者治疗前膝关节功能无统计学差异(P>0.05);两组患者经治疗后膝关节功能均有改善;清除术组患者经治疗后膝关节功能恢复较腔内注射组患者好。两组患者复发率无统计学差异(P>0.05)。结论关节腔内注射玻璃酸钠及关节镜下清理术都是治疗早期膝骨关节炎有效治疗方法。膝关节镜下清理术在短期疗效上优于关节腔内注射玻璃酸钠治疗。关节腔内注射玻璃酸钠治疗与关节镜下清理术治疗都不能根治膝骨关节炎。     

Comparison of proprioceptive functions between computerized proprioception facilitation exercise and closed kinetic chain exercise in patients with knee osteoarthritis

Aim The aim of this study was to compare proprioceptive function between computerized proprioception facilitation exercise (CPFE) and closed kinetic chain exercise (CKCE) for knee osteoarthritis. Design Randomized–controlled. Setting Kinesiology laboratory. Patients Eighty-one patients with bilateral knee osteoarthritis were randomly assigned to CPFE, CKCE, and control groups. Intervention Both exercise groups underwent an 8-week program of three sessions per week. The control group received no training. The CPFE program included a 20-min computer game to be played by the trained foot of the subject. CKCE included 10 sets of 10 repetitions of repeated knee extension and flexion with resistance of 10–25% of body weight. Main outcome measures Absolute reposition error, functional score, walking speed, and knee muscle strength were assessed with an electrogoniometer, the physical function subscale of Western Ontario and McMaster Osteoarthritis Index, a CASIO stopwatch, and a Cybex 6000 dynamometer before and after the 8-week period. Results The results of this study showed that both CPFE and CKCE were effective in improving joint position sense, functional score, walking speed, and muscle strength. Furthermore, CKCE showed greater effect in increasing knee extensor torque in patients with knee osteoarthritis. Conclusion Clinical effects of CPFE were the same as those of CKCE except for knee extensor torque. The increase in knee extensor torque in CPFE patients was not as great as that seen in CKCE patients. This study was orally presented at the Annual Research Conference of Physical Therapy Association of the Republic of China, Taipei, Taiwan. September 19, 2004. An erratum to this article can be found at     

The effect of isokinetic and aerobic exercises on serum interleukin-6 and tumor necrosis factor alpha levels,pain, and functional activity in patients with knee osteoarthritis

Objectives. The aim of this study is to investigate the effects of isokinetic and aerobic exercise training programs on serum pro-inflammatory cytokine levels, pain, and functional activity in patients with knee osteoarthritis (OA).

Methods. Forty-two postmenopausal women and men with knee OA according to American College of Rheumatology diagnostic criteria were included. Patients were randomized into isokinetic and aerobic exercises and control groups. In intervention groups, patients were included in predetermined exercise programs 3 times per week for 6 weeks. Severity of pain, functional activity status, muscle strength, functional capacity, and serum cytokine levels were evaluated at baseline and at the 6th week.

Results. At the end of 6th week, there was no statistically significant decrease in serum pro-inflammatory cytokine levels in both the exercise groups, although C-reactive protein levels exhibited a strong trend toward significance. We found a significant decrease in visual analog scale and Western Ontario McMaster Osteoarthritis Index scores, and significant increase in functional capacity and muscle strength in both the exercise groups compared with those in the control group.     

Effectiveness of exercise with or without thermal therapy for community-dwelling elderly Japanese women with non-specific knee pain: A randomized controlled trial

Knee pain is a common health problem in the elderly population, for which non-invasive treatments are recommended as a first line treatment in the management of knee pain. A randomized controlled trial was conducted to determine the effects of exercise with or without thermal therapy in community-dwelling elderly women with chronic knee pain. Women over 75 years of age with knee pain (n = 150) were randomly assigned into four groups; exercise (Ex) and heat/steam generating sheet (HSGS) (n = 38), Ex (n = 37), HSGS (n = 38), or health education (HE) (n = 37). The Ex group attended a 60-min comprehensive training program twice a week for 3-months. The HSGS group placed two sheets on the knee for five hours per day. Functional fitness, visual analog scale (VAS), and Japanese knee osteoarthritis measure (JKOM) were assessed at baseline and post-intervention. The results showed VAS improvements in the Ex + HSGS and HSGS groups. Total JKOM score, muscle strength, and functional mobility significantly improved in the Ex + HSGS group compared with the HE group. The odds ratio (OR) for VAS and functional mobility improvement was more than eight times as great in the Ex + HSGS group (OR = 8.60, 95% confidence interval (CI) = 2.82–32.73) compared with the education group. Ex or HSGS alone were insufficient in enhancing functional fitness or improving pain and quality of life. The combined effects of both Ex and heat therapy seems to have an added benefit of decreasing pain, improving physical function and increasing quality of life. Trial Registration Number: JMA-IIA00110.     

Improved function from progressive strengthening interventions after total knee arthroplasty: A randomized clinical trial with an imbedded prospective cohort

Objective

To determine the effectiveness of progressive quadriceps strengthening with or without neuromuscular electrical stimulation (NMES) on quadriceps strength, activation, and functional recovery after total knee arthroplasty (TKA), and to compare progressive strengthening with conventional rehabilitation.

Methods

A randomized controlled trial was conducted between July 2000 and November 2005 in an academic outpatient physical therapy clinic. Two hundred patients who had undergone primary, unilateral TKA for knee osteoarthritis were randomized to 1 of 2 interventions 4 weeks after surgery, and 41 patients eligible for enrollment who did not participate in the intervention were tested 12 months after surgery (standard of care group). All randomized patients received 6 weeks of outpatient physical therapy 2 or 3 times per week through 1 of 2 intervention protocols: an exercise group (volitional strength training) or an exercise‐NMES group (volitional strength training and NMES). Treatment effects were evaluated by a burst superimposition test to assess quadriceps strength and volitional activation 3 and 12 months postoperatively. The Medical Outcomes Study Short Form 36 and Knee Outcome Survey were completed. Knee range of motion, Timed Up and Go, Stair‐Climbing Test, and 6‐Minute Walk were also measured.

Results

Strength, activation, and function were similar between the exercise and exercise‐NMES groups at 3 and 12 months. The standard of care group was weaker and exhibited worse function at 12 months compared with both treatment groups.

Conclusion

Progressive quadriceps strengthening with or without NMES enhances clinical improvement after TKA, achieving similar short‐ and long‐term functional recovery and approaching the functional level of healthy older adults. Conventional rehabilitation does not yield similar outcomes.     

Effects of quadriceps electrical stimulation program on clinical parameters in the patients with knee osteoarthritis

The aim of this study was to evaluate the effects of electrical stimulation program on pain, disability, and quadriceps strength in the patients with knee osteoarthritis. Fifty women diagnosed as knee osteoarthritis were randomized into two groups as electrical stimulation and biofeedback-assisted isometric exercises. Both of the programs were performed 5 days a week, for a duration of 4 weeks. Outcome measures for pain were visual analogue scale pain score and Western Ontario McMaster osteoarthritis index (WOMAC) pain score. Disability and stiffness were assessed with WOMAC physical function and stiffness score. One repetition maximum (RM) and 10 RM were used for measuring quadriceps strength. In addition, 50 m walking time and 10 steps stairs climbing up-down time were evaluated. Both groups showed significant improvements in pain, physical function, and stiffness scores after the therapy. There were statistically significant improvements in 50 m walking time and 10 steps stairs climbing up-down time and 1 RM and 10 RM values indicating the improvement in muscle strength. In addition, there were no significant differences between the groups after the therapy. We conclude that electrical stimulation treatment was as effective as exercise in knee osteoarthritis and electrical stimulation treatment can be suggested especially for the patients who have difficulty in or contraindications to perform an exercise program.     

虾青素胶囊治疗膝关节骨性关节炎疗效观察

目的观察虾青素胶囊治疗膝关节骨性关节炎的疗效。方法将60例膝关节骨性关节炎患者随机分为治疗组(30例)和对照组(30例)。治疗组给予虾青素胶囊治疗,对照组给予芬必得治疗。比较两组治疗前后膝关节功能评分,观察主要症状缓解情况和治疗效果。结果 (1)治疗组的疼痛缓解持续时间较对照组缩短,而疼痛缓解时间较对照组延长(P均0.01);(2)两组治疗后关节功能较治疗前均有提高(P均0.01),而治疗组比对照组更优(P0.05);(3)总有效率治疗组为66.67%,对照组为83.33%,两组疗效比较差异无统计学意义(P0.05)。结论虾青素胶囊治疗骨性关节炎有一定的疗效。     

Effectiveness of behavior graded activity on exercise adherence and physical activity in hip and knee osteoarthritis – A systematic review

BackgroundOsteoarthritis (OA) has a major impact on daily life and often leads to avoidance of physical activity. A lack of regular physical activity in people with OA of the hip or knee is an important risk factor for further functional decline. Recently developed and evaluated exercise program called the behavioral graded activity (BGA) program acts as an approach to enhance adherence to exercises that lead to a more physically active lifestyle. The purpose of this systematic review is to identify Randomized Controlled Trials (RCT) on BGA interventions for hip and knee OA and to provide summary of current evidence.MethodsThe database searched with the keywords (knee osteoarthritis, hip osteoarthritis, behavior graded activity, behavior physical therapy, physical activity), in Cochrane Library (Cochrane Database of Systematic Reviews), PubMed, MEDLINE Plus, PEDro and CINAHL for studies published from January 2000 to May 2011. The randomized controlled trials included in the study assessed the effect of behavioral graded activity on hip and knee osteoarthritis.ResultsFour RCTs meeting the qualitative levels of evidence based on the grading system described by Tugwell and O'Shea (2004) and recommended by the Cochrane Musculoskeletal Group were considered for analysis and the results were projected.ConclusionThere is a silver level evidence that the BGA results in better exercise adherence and more physical activity than usual care in people with OA of the hip and knee, both in the short- and long-term.     

非甾体抗炎药联合肌松剂治疗膝关节骨关节炎的临床研究

目的对比研究非甾体抗炎药(NSAIDs)联合肌肉张力松弛剂与传统单纯NSAIDs治疗老年膝关节骨关节炎(OA)的临床疗效。方法门诊选取膝关节骨关节炎患者129例,随机分组,单盲给药,联合用药组和两个对照组各43例。联合用药组给予环氧化酶-2(COX-2)抑制剂罗非昔布及肌肉张力松弛剂盐酸乙哌立松,另两组分别单独给予罗非昔布和盐酸乙哌立松。比较三组用药后临床症状改善情况并作统计学分析。结果经8周治疗后平均Womac关节炎指数评分和平均OA严重程度指数改善联合用药组均显著优于两单独用药组。联合用药组显效率较另两组高,差异有显著性(P<0.05)。结论通过两种不同药理作用的联合———NSAIDs的抗炎作用与肌松剂的缓解疼痛及痉挛作用,可使膝关节骨关节炎的临床疗效得到进一步提高。     

复元胶囊对膝骨关节炎的疗效及机制

目的观察复元胶囊治疗膝骨关节炎(KOA)的临床疗效及机制。方法将60例辨证为肝肾不足、筋脉瘀滞证的KOA患者随机分为两组,治疗组予以复元胶囊口服,随机对照组予以仙灵骨葆胶囊口服。在治疗前后评定KOA严重性指数(ISOA)及中医症候积分,观察临床疗效和不良反应。治疗前后收集血清,采用酶联免疫吸附试验检测透明质酸(HA)的表达变化。结果治疗组、对照组均可明显缓解疼痛,改善膝关节功能。治疗组总有效率90.00%,对照组总有效率86.67%;两组治疗前后ISOA积分、中医症候积分均显著下降(P<0.05),组间无显著性差异(P>0.05)。治疗前治疗组、对照组血清HA水平较健康组明显增高(P<0.05);治疗后治疗组和对照组血清HA水平较治疗前明显降低(P<0.05)。治疗过程中,患者未出现严重不良反应。结论复元胶囊能有效缓解肝肾不足、筋脉瘀滞证KOA患者症状,可能通过降低HA的表达起作用。