Sensory-motor training versus resistance training among patients with knee osteoarthritis: randomized single-blind controlled trial

ABSTRACT BACKGROUND: Osteoarthritis of the knee is defined as a progressive disease of the synovial joints and is characterized by failure of joint damage repair. The objective here was to compare the effectiveness of sensory-motor training versus resistance training among patients with knee osteoarthritis. DESIGN AND SETTING: Randomized, single-blinded controlled trial conducted at the outpatient service of the University of Santo Amaro. METHODS: A total of 64 patients were randomly assigned to sensory-motor training or resistance training. The evaluations were performed at baseline and 16 weeks after the intervention and included pain evaluation on a visual analogue scale, isometric quadriceps femoris force measurement using a dynamometer, Timed Up and Go test, Tinetti balance scale, Western Ontario and McMaster Universities osteoarthritis index, and the SF-36 quality-of-life questionnaire. Data analysis was performed using analysis of variance with repeated measurements and Cohen’s effect size. RESULTS: Sensory-motor training may be a plausible alternative and showed a small effect on pain and a medium effect on maximal voluntary isometric contraction. Resistance training showed a small effect on balance and a medium effect on mobility. CONCLUSION: Resistance training and sensory motor training for the lower limbs among patients with knee osteoarthritis seemed to present similar effects on pain and function. However, because there was a considerable risk of type 2 error, further randomized clinical trials are still needed to provide a sound conclusion.

研究背景：膝骨关节炎是一类进展性滑膜关节疾病，以关节损伤修复失败为典型特征。本研究旨在对比感觉运动训练（sensory-motor training）与抗阻训练（resistance training）在膝骨关节炎患者中的干预效果。
研究设计与实施场景：本研究为单盲随机对照试验，于圣阿马罗大学（University of Santo Amaro）门诊开展。
研究方法：共纳入64例膝骨关节炎患者，按随机原则分配至感觉运动训练组与抗阻训练组。评估于基线及干预后16周分别进行，评估指标涵盖：视觉模拟评分法（visual analogue scale，VAS）疼痛评估、采用测力计（dynamometer）测量股四头肌等长肌力、计时起立行走试验（Timed Up and Go test）、Tinetti平衡量表、西安大略和麦克马斯特大学骨关节炎指数（Western Ontario and McMaster Universities osteoarthritis index，WOMAC）以及SF-36生活质量问卷。数据分析采用重复测量方差分析与科恩效应量（Cohen’s effect size）进行。
研究结果：感觉运动训练或为合理的备选干预方案，其对疼痛的改善效应量为小，对最大自主等长收缩肌力的效应量为中等；抗阻训练对平衡能力的效应量为小，对移动能力的效应量为中等。
研究结论：针对膝骨关节炎患者的下肢感觉运动训练与抗阻训练，在改善疼痛与关节功能方面效果相近。但本研究存在较高的Ⅱ类错误风险，仍需开展更多随机对照试验以得出严谨可靠的结论。