The effect of exercise therapy on inflammatory activity assessed by MRI in knee osteoarthritis: Secondary outcomes from a randomized controlled trial
The effect of exercise therapy on inflammatory activity assessed by MRI in knee osteoarthritis: Secondary outcomes from a randomized controlled trial
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DOI：
10.1016/j.knee.2020.12.022
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发表时间：
2021-01-13
期刊：
影响因子：
1.9
通讯作者：
Henriksen, Marius
中科院分区：
文献类型：
--
作者：
Bandak, Elisabeth;Boesen, Mikael;Henriksen, Marius
目的：本研究通过磁共振成像 (MRI) 评估运动疗法对膝关节 OA 患者滑膜炎和骨髓病变 (BML) 炎症活动的影响。方法：60 名膝关节 OA 患者按 1:1 随机分配至 12 周的监督运动疗法 3 次/周 (ET) 或无注意对照组 (CG)。使用带或不带造影剂的静态 MRI 和动态造影增强 MRI 评估滑膜炎和 BML。 （DCE-MRI）。 DCE-MRI 数据使用基于信号强度曲线分析的逐像素方法进行量化。通过膝关节损伤和骨关节炎结果评分（KOOS）评估疼痛。使用协方差分析来评估从基线到第 12 周的变化的组间差异。结果：33 名患者遵守了方案并拥有有效的 MRI 和 KOOS 数据（ET，n = 16，CG，n = 17）。在 KOOS 疼痛变化中观察到有利于 ET 的统计学显着性和临床相关性组差异（-11.7 分，95% CI：-20.1 至 -3.4）。与 CG 相比，ET 组前滑膜炎的 DCE-MRI 评估存在统计学显着组间差异，且炎症活动未改变。 BML 和静态 MRI 没有组间差异。结论：与不注意的对照组相比，坚持 12 周运动治疗的膝关节 OA 患者的炎症活动没有变化，疼痛减轻。疼痛的减轻不能用炎症活动的变化来解释。总体而言，结果表明运动对膝关节骨关节炎没有害处。 (C) 2021 Elsevier B.V. 保留所有权利。
Objective: This study investigated the effect of exercise therapy on inflammatory activity in synovitis and bone marrow lesions (BMLs) assessed by magnetic resonance imaging (MRI) in patients with knee OA.Methods: 60 patients with knee OA were randomized 1:1 to 12 weeks of supervised exercise therapy 3 times/week (ET) or a no-attention control group (CG).Synovitis and BMLs were assessed with static MRI with and without contrast and with dynamic contrast enhanced MRI (DCE-MRI). DCE-MRI data was quantified using pixel-by-pixel methodology based on analysis of signal intensity curves. Pain was assessed by the Knee Injury and Osteoarthritis Outcome Score (KOOS). Analyses of covariance were used assessing group differences in changes from baseline to week 12.Results: 33 patients adhered to the protocol and had valid MRI and KOOS data (ET, n = 16, CG, n = 17). Statistically significant and clinically relevant group difference in favour of ET was seen in KOOS pain change (-11.7 points, 95%CI: -20.1 to -3.4). There were statistically significant group differences in DCE-MRI assessed synovitis in the anterior synovium with unchanged inflammatory activity in the ET group compared to the CG. There were no group differences in BMLs and static MRI.Conclusion: Inflammatory activity was unchanged, and pain was reduced in patients with knee OA adhering to 12 weeks of exercise therapy compared to a no-attention control group. The reduction in pain was not explained by changes in inflammatory activity. Overall, the results suggest that exercise is not harmful in knee OA. (C) 2021 Elsevier B.V. All rights reserved.