SUPERVISED FITNESS WALKING IN PATIENTS WITH OSTEOARTHRITIS OF THE KNEE - A RANDOMIZED, CONTROLLED TRIAL
SUPERVISED FITNESS WALKING IN PATIENTS WITH OSTEOARTHRITIS OF THE KNEE - A RANDOMIZED, CONTROLLED TRIAL
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DOI：
10.7326/0003-4819-116-7-529
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发表时间：
1992-04-01
影响因子：
39.2
通讯作者：
CHARLSON, ME
中科院分区：
文献类型：
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作者：
KOVAR, PA;ALLEGRANTE, JP;CHARLSON, ME
目的：评价健美步行和患者教育对膝骨性关节炎患者功能状态、疼痛和用药情况的影响。设计：为期8周的随机对照试验。地点：某学术医学中心骨科医院的住院和门诊服务。患者：102例确诊为单膝或双膝原发性骨关节炎的患者。51名干预患者中的47名和51名对照组患者中的45名获得了数据。干预：为期8周的健身步行和患者教育或标准常规医疗护理计划。测量：在干预前后通过6分钟的步行距离测试和关节炎影响评定量表(AIMS)的体力活动、关节炎影响、疼痛和药物分量表(AIMS)的分数来评估患者和评估结果。结果：随机分配到步行计划的患者步行距离比基线评估增加了70米，改善了18.4%(95%可信区间，9.8%至27.0%)。相比之下，对照组的步行距离比他们的基线评估减少了17米(P<；0.001)。通过AIMS体力活动子量表测量的功能状态的改善在步行组也被观察到，但在对照组中没有(P<；0.001)；被分配到步行计划的患者改善了39%(CI，15.6%到60.4%)。虽然两组在关节炎影响子量表上的评分变化相似(P=0.093)，但步行组的关节炎疼痛减少了27%(CI，9.6%至41.4%)(P=0.003)。步行组用药频度低于对照组(P=0.08)。结论：在不加重膝关节骨性关节炎患者疼痛或加重关节炎相关症状的情况下，有监督的健身步行和患者教育方案可改善膝关节功能状态。
Objective: To assess the effect of a program of supervised fitness walking and patient education on functional status, pain, and use of medication in patients with osteoarthritis of the knee.Design: An 8-week randomized, controlled trial.Setting: Inpatient and outpatient services of an orthopedic hospital in an academic medical center.Patients: A total of 102 patients with a documented diagnosis of primary osteoarthritis of one or both knees participated in the study. Data were obtained on 47 of 51 intervention patients and 45 of 51 control patients.Interventions: An 8-week program of supervised fitness walking and patient education or standard routine medical care.Measurements: Patients were evaluated and outcomes assessed before and after the intervention using a 6-minute test of walking distance and scores on the physical activity, arthritis impact, pain, and medication subscales of the Arthritis Impact Measurement Scale (AIMS).Results: Patients randomly assigned to the walking program had a 70-meter increase in walking distance relative to their baseline assessment, which represents an improvement of 18.4% (95% CI, 9.8% to 27.0%). In contrast, controls showed a 17-meter decrease in walking distance relative to their baseline assessment (P < 0.001). Improvements in functional status as measured by the AIMS physical activity subscale were also observed in the walking group but not in the control group (P < 0.001); patients assigned to the walking program improved 39% (CI, 15.6% to 60.4%). Although changes in scores on the arthritis impact subscale were similar in the two groups (P = 0.093), the walking group experienced a decrease in arthritis pain of 27% (CI, 9.6% to 41.4%) (P = 0.003). Medication use was less frequent in the walking group than in the control group at the post-test (P = 0.08).Conclusions: A program of supervised fitness walking and patient education can improve functional status without worsening pain or exacerbating arthritis-related symptoms in patients with osteoarthritis of the knee.