A home-based protocol of electrical muscle stimulation for quadriceps muscle strength in older adults with osteoarthritis of the knee.
A home-based protocol of electrical muscle stimulation for quadriceps muscle strength in older adults with osteoarthritis of the knee.
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发表时间：
2003-07
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通讯作者：
L. Talbot;Jean M. Gaines;S. Ling;E. Metter
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作者：
L. Talbot;Jean M. Gaines;S. Ling;E. Metter
目的：确定应用于股四头肌（QF）肌肉的家庭神经肌肉电刺激（NMES）是否能增加膝关节骨关节炎（OA）老年人的力量、体力活动和身体表现。方法：34例经X线片证实的症状性膝关节OA成人（> 60岁）被随机分为NMES+教育组或仅教育组（EDU）。主要结局是等长QF峰值扭矩（PTIso），次要结局是每日步数、总活动向量幅度、100英尺步行-转身-步行、定时爬楼梯、椅子起身和疼痛。NMES组每周3天使用便携式电肌肉刺激器进行单侧QF训练，在12周内将等长收缩强度递增至最大值的30-40%。两组都接受了为期12周的关节炎自我管理课程，并再随访12周。结果：受刺激的膝伸肌在120度PTIso中显示出9.1%的增加，而EDU组中显示出7%的损失（120度PTIso的时间x组相互作用; p = 0.04）。NMES组的椅子上升时间减少了11%，而EDU组减少了7%（p = 0.01，时间; p = 0.9，组）。同样，两组的步行时间均改善了约7%（p = 0.02，时间; p = 0.61组）。干预后报告的疼痛严重程度在两组之间没有差异。结论：在膝关节OA老年患者中，家庭NMES方案似乎是一种有前途的治疗方法，可以增加膝关节OA成人患者的QF强度，而不会加剧疼痛症状。
OBJECTIVE To determine whether home-based neuromuscular electrical stimulation (NMES) applied to the quadriceps femoris (QF) muscle increases strength, physical activity, and physical performance in older adults with knee osteoarthritis (OA). METHODS Thirty-four adults (> 60 yrs) with radiographically confirmed symptomatic knee OA were randomized to NMES plus education or education only (EDU). The primary outcome was isometric QF peak torque (PTIso), with secondary outcomes of daily step counts, total activity vector magnitude, 100-foot walk-turn-walk, timed stair climb, chair rise, and pain. The NMES group used a portable electrical muscle stimulator 3 days a week for unilateral QF training with incremental increases in the intensity of isometric contraction to 30-40% of maximum over 12 weeks. Both groups received the 12-week Arthritis Self-Management course and were followed an additional 12 weeks. RESULTS The stimulated knee-extensor showed a 9.1% increase in 120 degrees PTIso compared to a 7% loss in the EDU group (time x group interaction for 120 degrees PTIso; p = 0.04). The chair rise time decreased by 11% in the NMES group, whereas the EDU group saw a 7% reduction (p = 0.01, time; p = 0.9, group). Similarly, both groups improved their walk time by approximately 7% (p = 0.02, time; p = 0.61 group). Severity of pain reported following intervention did not differ between groups. CONCLUSION In older adults with knee OA, a home-based NMES protocol appears to be a promising therapy for increasing QF strength in adults with knee OA without exacerbating painful symptoms.