Task Specific Exercise Training versus Graded Motor Imagery on Pain, Function, Knee Muscle Torque and Task Performance for Knee Osteoarthritis

Background: Individuals with knee osteoarthritis (OA) might not be comfortable with vigorous manual therapy approaches due to severe pain. Complementary therapies can be effective in such situations. Task specific exercise training (TSET) and graded motor imagery (GMI) are two such therapies which are less explored for their effectiveness in knee OA. So, the aim of this study was to determine and compare the effects of TSET and GMI on pain, function, task performance, mobility and muscle torque in knee OA.
Methods: Thirty-two individuals aged 40-65 years with grade 2 and above knee OA and pain intensity of > 4 on verbal scale were randomly assigned to TSET (n=16) and GMI (n=16) groups who received intervention thrice a week for 3 weeks. Pre (session 1) and post (session 9) outcome analysis was done for pain intensity by Numerical Pain Rating Scale, Knee injury and osteoarthritis outcome score for quality of life (QOL), three performance-based tests [30-second chair climb test, timed stair climb test and floor transfer test], peak torque and ratio for quadriceps and hamstrings using Isokinetic testing system and knee range of motion by goniometry.
Results: Statistically significant difference was seen within both groups for all the outcomes (P<0.05). Both groups were equally effective for pain (P= 0.731), QOL (P=0.863) as well as all the objective based outcomes (performance-based tests, knee ROM, peak torque and ratio)
Conclusion: Both TSET and GMI are effective complementary therapy approaches to treat knee OA in terms of pain, function and task performance.

背景：患有膝关节骨关节炎（OA）的个体可能因剧烈疼痛而不适应剧烈的手法治疗。在此类情况下，辅助性治疗可能更为有效。特定任务锻炼训练（TSET）和分级运动想象（GMI）即为此类疗法，它们在膝关节OA治疗中的有效性研究较少。因此，本研究旨在确定并比较TSET和GMI对疼痛、功能、任务表现、活动能力和肌肉扭矩在膝关节OA中的作用。方法：将32名年龄在40至65岁之间、膝关节OA分级为2级及以上且疼痛强度在言语量表上大于4分的个体随机分配到TSET组（n=16）和GMI组（n=16），他们每周接受三次干预，共3周。通过数字疼痛评分量表对疼痛强度进行前（第1次会话）和后（第9次会话）结果分析，使用膝关节损伤和骨关节炎结果评分对生活质量（QOL）进行评估，进行三项基于表现力的测试[30秒椅子攀登测试、计时楼梯攀登测试和地面转移测试]，使用等速测试系统测定股四头肌和腘绳肌的峰值扭矩和比值，以及通过量角器测定膝关节活动范围。结果：两组在所有结果指标上均显示出统计学上的显著差异（P<0.05）。两组在疼痛（P=0.731）、生活质量（P=0.863）以及所有基于客观指标的结果（基于表现力的测试、膝关节活动范围、峰值扭矩和比值）方面均具有同等效果。结论：TSET和GMI均是治疗膝关节OA的疼痛、功能和任务表现的有效辅助治疗手段。