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.

摘要

## 背景
膝骨关节炎（knee osteoarthritis）是一类进展性滑膜关节疾病，以关节损伤修复失败为核心特征。本研究旨在比较感觉运动训练（sensory-motor training）与抗阻训练（resistance training）应用于膝骨关节炎患者的临床疗效。

## 研究设计与实施场所
本研究为于圣阿马罗大学门诊开展的随机单盲对照试验（randomized, single-blinded controlled trial）。

## 研究方法
共计64名膝骨关节炎患者被随机分配至感觉运动训练组或抗阻训练组。分别于基线及干预后16周完成评估，评估内容包括：采用视觉模拟评分法（visual analogue scale）评估疼痛程度、使用肌力测力计（dynamometer）测量股四头肌等长肌力、计时起立-行走测试（Timed Up and Go test）、廷尼平衡量表（Tinetti balance scale）、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，简称WOMAC指数）以及SF-36生活质量问卷（SF-36 quality-of-life questionnaire）。数据分析采用重复测量方差分析（analysis of variance with repeated measurements）与科恩效应量（Cohen’s effect size）。

## 研究结果
感觉运动训练或可作为可行的替代干预方案，其对疼痛的效应量较小，对最大自主等长收缩的效应量为中等水平。抗阻训练对平衡能力的效应量较小，对移动能力的效应量为中等水平。

## 结论
针对膝骨关节炎患者的下肢抗阻训练与感觉运动训练，在疼痛缓解与功能改善方面效果相近。但鉴于本研究存在较大的Ⅱ类错误（type 2 error）风险，仍需开展进一步的随机临床试验以得出更为可靠的结论。