Effects of a therapeutic exercises program associated with pompage technique on pain, balance and strength in elderly women with knee osteoarthritis

Abstract Introduction: Knee Osteoarthritis (OA) affects mainly elderly, being characterized by arthralgia, stiffness and strength and balance deficits. Scientific evidence suggests beneficial effects of exercise therapy on these changes, but lacks detailed protocols. In addition, there were published studies on effects of therapeutic exercise associated with pompage that were not located. Objective: To investigate the effects of a therapeutic exercise program associated with pompage on pain, balance and muscle strength in elderly women with knee osteoarthritis. Methods: A randomized pilot clinical trial that included 22 women (60 - 80 years) diagnosed with knee OA, randomized and allocated by simple raffle into two groups: intervention and control. Intervention group (strengthening and balance exercises and knee pompage) performed two sessions per week for 12 weeks. The control group received educational lectures, they were evaluated before and after 12 weeks: arthralgia- subscale pain of the Western Ontario and McMaster Universities Osteoarthritis Index questionnaire (WOMAC); postural stability- postural balance protocol by Biodex Balance SD and muscle strength- concentric peak torque of the knee extensor by isokinetic dynamometer. The Independent Student t test was used for intergroup analysis. Results: The intervention group compared with the control showed better results for the outcomes pain, balance and muscle strength after 12 weeks. However, the difference was statistically significant (p < 0.05) for levels of antero-posterior oscillation (DM -0.28, 95% CI -0.54 a -0.02; p = 0.035) and global oscillation (DM -0.36, 95% CI -0.68 a -0.04; p = 0.028). Conclusion: The intervention had a positive effect on postural balance in elderly women with knee osteoarthritis.

摘要 引言：膝骨关节炎（Knee Osteoarthritis, OA）主要累及老年人群，以关节痛、僵硬及肌力与平衡功能缺损为主要特征。现有科学证据表明运动疗法对上述症状改善具有积极作用，但缺乏详细的实施方案。此外，已有关于治疗性运动联合按压疗法（pompage）干预效果的研究发表，但本研究未检索到相关文献。
研究目的：探讨治疗性运动联合按压疗法（pompage）对膝骨关节炎老年女性患者疼痛、平衡功能及肌力的影响。
研究方法：本研究为随机对照预试验，共纳入22名年龄60~80岁、确诊为膝骨关节炎的女性受试者，通过简单抽签法随机分为干预组与对照组。干预组每周进行2次训练，持续12周，训练内容包括肌力与平衡训练及膝关节按压疗法（pompage）。对照组仅接受健康教育讲座。分别于干预前及干预12周后对两组受试者进行以下评估：①疼痛症状：采用西部安大略省与麦克马斯特大学骨关节炎指数问卷（Western Ontario and McMaster Universities Osteoarthritis Index, WOMAC）疼痛亚量表；②姿势稳定性：采用Biodex Balance SD平衡评估系统进行平衡功能检测；③肌力水平：采用等速肌力测力计检测膝伸肌的向心峰力矩。组间比较采用独立样本t检验。
研究结果：干预12周后，干预组在疼痛、平衡功能及肌力指标上均优于对照组；其中前后向振荡幅度（均数差-0.28，95%置信区间-0.54~-0.02；p=0.035）及整体振荡幅度（均数差-0.36，95%置信区间-0.68~-0.04；p=0.028）的组间差异具有统计学意义（p<0.05）。
研究结论：该干预方案对膝骨关节炎老年女性患者的姿势平衡功能具有积极改善作用。