期刊
OSTEOARTHRITIS AND CARTILAGE
卷 25, 期 4, 页码 470-480出版社
ELSEVIER SCI LTD
DOI: 10.1016/j.joca.2016.10.022
关键词
Osteoarthritis; Exercise; Gait; Knee joint; Knee; Pain management
资金
- Region of Southern Denmark PhD Fund
- Region of Southern Denmark Research Fund
- Danish Rheumatism Association
- Danish Rheumatism Association Ryholts grant
- University of Southern Denmark Scholarship
- Association of Danish Physiotherapists
- Odense University Hospital free research funds
- Family Hede Nielsens Fund
- Oak Foundation
Objective: To investigate the effect of a neuro-muscular exercise (NEMEX) therapy program compared with instructions in optimized analgesics and anti-inflammatory drug use (PHARMA), on measures of knee-joint load in people with mild to moderate knee osteoarthritis (OA). We hypothesized that knee joint loading during walking would be reduced by NEMEX and potentially increased by PHARMA. Design: Single-blind, randomized controlled trial (RCT) comparing NEMEX therapy twice a week with PHARMA. Participants with mild-to-moderate medial tibiofemoral knee OA were randomly allocated (1:1) to one of two 8-week treatments. Primary outcome was change in knee load during walking (Knee Index, a composite score from all three planes based on 3D movement analysis) after 8 weeks of intervention. Secondary outcomes were frontal plane peak knee adduction moment (KAM), Knee Injury and Osteoarthritis Outcome Scores (KOOS) and functional performance tests. Results: Ninety three participants (57% women, 58 +/- 8 years with a body mass index [BMI] of 27 +/- 4 kg/m(2) (mean +/- standard deviation [SD])) were randomized to NEMEX group (n = 47) or PHARMA (n = 46); data from 44 (94%) and 41 (89%) participants respectively, were available at follow-up. 49% of the participants in NEMEX and only 7% in PHARMA demonstrated good compliance. We found no difference in the primary outcome as evaluated by the Knee Index -0.07 [-0.17; 0.04] Nm/%BW HT. Secondary outcomes largely supported this finding. Conclusions: We found no difference in the primary outcome; knee joint load change during walking from a NEMEX program vs information on the recommended use of analgesics and anti-inflammatory drugs. (C) 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
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