不同神经肌肉训练方法对早期膝骨关节炎患者疼痛和运动功能效果的比较

doi:10.3969/j.issn.1006-9771.2023.09.013

Abstract

Abstract:

Objective To compare the effect of proprioceptive neuromuscular training methods on pain and motor ability of knee in patients with early knee osteoarthritis (KOA).

Methods From November, 2022 to May, 2023, 60 early KOA patients from Beijing Bo'ai Hospital and community were randomly divided into groups A, B and C, with 20 patients in each group. Group A received proprioceptive neuromuscular facilitation (PNF), group B received neuromuscular exercise (NEMEX), and group C received PNF and NEMEX, for six weeks. They were assessed with Visual Analogue Scale for pain (VAS), angle reappearance test, difference of pre-motor reaction time (VM-VL), active range of motion (AROM) of knee flexion, 10-meter walk test (10MWT), and Knee Injury and Osteoarthritis Outcome Score (KOOS) before and after treatment.

Results All the indexes improved in all the groups after treatment (|t| > 2.532, P < 0.05). Among the groups, the VAS score was the least in group A, and then groups C and B; the angle reappearance error was the least in group C, and similar in groups A and B; the VM-VL was the least in groups A and C, followed by group B.

Conclusion PNF, NEMEX and PNF+NEMEX can relieve the pain and improve the motor function of knee in patients with early KOA, however, PNF is the most effective on relieving pain, and PNF+NEMEX is the most effective on improving knee function.

Key words: knee osteoarthritis, pain, proprioception, proprioceptive neuromuscular facilitation, neuromuscular exercise, reaction time

CLC Number:

R684.3

ZHANG Guancong, HUANG Qiuchen, GU Rui, LIU Sihai, HU Chunying, LIU Kemin. Comparative effect of different neuromuscular exercises on pain and motor function of knee in patients with early knee osteoarthritis[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1090-1097.

Figures/Tables 7

References 35

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组别	n	性别(男/女)/n	年龄/岁	身高/cm	体质量/kg	体质量指数/(kg·m^-2)
A组	20	8/12	57.55±5.14	166±8.10	76.35±14.67	27.26±4.49
B组	20	8/12	57.85±4.10	167±7.62	75.45±16.05	26.80±4.49
C组	20	8/12	56.55±4.01	166±6.17	74.60±15.01	26.84±4.79
χ²/F值		0	0.467	0.06	0.066	0.064
P值		1	0.629	0.942	0.936	0.938

组别	n	治疗前	治疗后	t值	P值
A组	20	5.01±1.19	1.82±0.67	23.602	< 0.001
B组 C组	20	5.17±1.16 5.02±1.42	4.19±1.26^a 2.76±0.91^a,b	13.052 14.960	< 0.001
B组 C组	20	5.17±1.16 5.02±1.42	4.19±1.26^a 2.76±0.91^a,b	13.052 14.960	< 0.001
F值		0.097	29.938
P值		0.907	< 0.001

组别	n	治疗前	治疗后	t值	P值
A组	20	12.21±2.00	5.25±1.03	29.754	< 0.001
B组 C组	20	12.83±2.03 11.88±2.06	5.38±1.41 2.58±1.42^a,b	47.376 55.736	< 0.001
B组 C组	20	12.83±2.03 11.88±2.06	5.38±1.41 2.58±1.42^a,b	47.376 55.736	< 0.001
F值		1.129	29.536
P值		0.331	< 0.001

动作	组别	n	治疗前	治疗后	t值	P值
坐-站	A组	20	542.82±379.68	159.84±125.45	6.658	< 0.001
	B组	20	425.96±287.66	286.38±146.84^a	4.123	0.001
	C组	20	528.59±471.61	117.28±86.90^b	4.750	< 0.001
下台阶	A组	20	186.16±114.85	62.79±49.03	8.147	< 0.001
	B组	20	176.71±136.10	104.88±68.42^a	4.554	< 0.001
	C组	20	179.08±101.10	14.89±68.66^a,b	17.281	< 0.001
F值^①			0.543	10.351
P值^①			0.584	< 0.001
F值^②			0.035	10.309
P值^②			0.966	< 0.001

组别	n	治疗前	治疗后	t值	P值
A组	20	107.10±5.13	114.23±6.11	-10.910	< 0.001
B组	20	108.62±5.24	111.88±5.98	-3.143	0.005
C组	20	107.22±4.86	111.55±6.78	-3.665	0.002
F值		0.556	1.074
P值		0.576	0.348

Comparative effect of different neuromuscular exercises on pain and motor function of knee in patients with early knee osteoarthritis

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组别	n	治疗前	治疗后	t值	P值
A组	20	12.59±1.66	11.61±1.93	3.440	0.003
B组	20	12.05±1.71	11.28±1.99	2.532	0.020
C组	20	12.40±1.58	11.37±1.87	3.331	0.004
F值		0.555	0.151
P值		0.577	0.860

子项	组别	n	治疗前	治疗后	t值	P值
疼痛	A组	20	41.81±5.37	49.44±5.45	-8.966	< 0.001
	B组	20	41.94±5.90	49.86±5.37	-12.899	< 0.001
	C组	20	41.67±5.56	50.14±5.73	-16.522	< 0.001
症状	A组	20	46.25±8.07	62.68±10.00	-7.781	< 0.001
	B组	20	45.54±8.96	63.39±11.52	-7.265	< 0.001
	C组	20	47.14±8.64	62.14±11.95	-6.890	< 0.001
ADL	A组	20	51.25±5.53	52.79±4.96	-6.185	< 0.001
	B组	20	51.40±5.03	53.38±3.06	-2.932	0.009
	C组	20	51.32±5.62	53.60±5.12	-3.037	0.007
运动与娱乐能力	A组	20	24.25±10.17	40.00±17.32	-5.547	< 0.001
	B组	20	24.00±8.83	36.25±17.08	-4.801	< 0.001
	C组	20	24.00±8.97	37.50±17.43	-5.206	< 0.001
QOL	A组	20	37.19±11.56	53.75±17.37	-9.668	< 0.001
	B组	20	37.81±11.01	52.19±10.19	-7.667	< 0.001
	C组	20	34.69±9.82	53.75±12.73	-13.658	< 0.001
F值^①			0.012	0.080
P值^①			0.988	0.923
F值^②			0.177	0.063
P值^②			0.838	0.939
F值^③			0.004	0.174
P值^③			0.996	0.841
F值^④			0.005	0.244
P值^④			0.995	0.784
F值^⑤			0.467	0.086
P值^⑤			0.629	0.918

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