个性化神经肌训练对膝关节骨关节炎患者膝关节功能、疼痛、僵硬症状、生活质量的影响研究

目的探讨个性化神经肌训练对膝关节骨关节炎(knee osteoarthritis，KOA)患者膝关节功能、疼痛、僵硬症状、生活质量的影响。方法选取本院收治的150例KOA患者，按随机数表法分为观察组与对照组，每组75例。对照组采取抗阻训练，观察组采取个性化神经肌训练（包括热身运动、神经肌训练、冷身运动），治疗时间均为6周。比较两组总有效率、治疗前后的疼痛与僵硬症状［采用西安大略和麦克马斯特大学骨关节炎指数(Western Ontario and McMaster Universities，WOMAC)评估］、30 s椅子坐起试验、40 m快走试验、入组前2周内止痛药使用率、血清肿瘤坏死因子α(tumor necrosis factor-α，TNF-α)、白细胞介素6(interleukin-6，IL-6)、白细胞介素1β(interleukin-1β，IL-1β)水平及治疗结束后2周内的止痛药使用率、治疗前后的膝关节功能［采用膝关节协会评分（knee society score，KSS）评估］、生活质量［采用关节炎生活质量测量量表2-短卷（arthritis impact measurement scale 2-short form，AIMS2-SF）评估］。结果观察组总有效率高于对照组（P＜0.05），治疗后，两组疼痛症状评分、僵硬症状评分、日常活动难度评分、WOMAC总分较治疗前均下降，观察组低于对照组（P＜0.05）。治疗后，两组30 s椅子坐起试验、40 m快走试验和止痛药使用率均优于治疗前，观察组优于对照组（P＜0.05）。治疗后，两组血清TNF-α、IL-6、IL-1β均低于治疗前，观察组低于对照组（P＜0.05）。两组KSS评分和AIMS2-SF评分呈现升高，观察组优于对照组，组间、时点间、组间·时点间差异有统计学意义（P＜0.05）。结论个性化神经肌训练可提高下肢稳定性和协调性，并抑制炎症，改善疼痛与僵硬症状，有利于患者躯体功能、膝关节功能和生活质量的提高。

Effects of personalized neuromuscular training on knee function,pain, stiffness and quality of life in patients with knee osteoarthritis

ObjectiveTo explore the effect of personalized neuromuscular training on knee function, pain, stiffness and quality of life in patients with knee osteoarthritis(KOA).MethodsA total of 150 KOA patients treated in our hospital were selected and divided into observation group(n=75) and control group(n=75) by random number table method. The control group received resistance training, and the observation group received personalized neuromuscular training(including warm-up exercise, neuromuscular training, and cool-down exercise). The duration of treatment was 6 weeks. The total effective rate, pain and stiffness before and after treatment ［as assessed by the Western Ontario and McMaster University Osteoarthritis Index(WOMAC)］, 30 s chair-rising test, 40 m brisk walking test, the rate of analgesic use within 2 weeks before enrollment, serum tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), interleukin-1β(IL-1β) levels, the rate of analgesic use within 2 weeks after treatment, knee function before and after treatment ［assessed by knee society score(KSS)］, quality of life ［measured by arthritis impact measurement scale 2-short form(AIMS2-SF)］.ResultsThe total effective rate of the observation group was higher than that of the control group(P＜0.05). The pain symptom score, stiffness symptom score, daily activity difficulty score, and total WOMAC score were decreased in both groups after treatment, as compared with those before treatment, and the scores were lower in the observation group than in the control group(P＜0.05). After treatment, 30 s chair-rising test, 40 m brisk walking test, and the rate of analgesic use within 2 weeks before enrollment were better than those before treatment, which were better in the observation group than in the control group(P＜0.05). After treatment, serum TNF-α, IL-6, and IL-1β levels of the two groups were lower than those before treatment, and the levels were lower in the observation group than in the control group(P＜0.05). The KSS scores and AIMS2-SF scores showed an increasing trend, which were higher in the observation group than in the control group, and there were significant differences between groups, time points and time points between groups(P＜0.05).ConclusionPersonalized neuromuscular training can improve the stability and coordination of the lower limbs, inhibit inflammation, improve the pain and stiffness of patients, and help improve the patient′s physical function, knee function and quality of life.