Agility and Perturbation Training Techniques in Exercise Therapy for Reducing Pain and Improving Function in People With Knee Osteoarthritis: A Randomized Clinical Trial
Agility and Perturbation Training Techniques in Exercise Therapy for Reducing Pain and Improving Function in People With Knee Osteoarthritis: A Randomized Clinical Trial
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DOI：
10.2522/ptj.20100188
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发表时间：
2011-04-01
期刊：
影响因子：
3.2
通讯作者：
Irrgang, James J.
中科院分区：
文献类型：
--
作者：
Fitzgerald, G. Kelley;Piva, Sara R.;Irrgang, James J.
背景。基于损伤的运动项目在减轻膝关节骨关节炎（OA）患者的疼痛和改善功能方面只产生了很小到中等程度的益处。先前有人提出，在膝关节OA患者的运动计划中加入敏捷性和扰动训练可能会改善疼痛和功能的治疗效果。本研究的目的是检验在标准运动疗法中加入敏捷和扰动技术与单独的标准运动方案相比对膝关节oa患者的有效性。这是一项单盲随机对照试验。这项研究是在一家大型大学健康中心的门诊物理治疗诊所进行的。183名膝关节炎患者（122名女性，61名男性）参与了研究。参与者被随机分为两组，一组接受敏捷性和扰动训练，另一组接受标准运动疗法，另一组只接受标准运动方案。结果测量是自我报告的膝关节疼痛和功能、自我报告的膝关节不稳定性、基于表现的功能测量和整体变化评级。尽管在2个月、6个月和12个月的随访期间，两组在自我报告的功能和总体变化评分方面都有所改善，但在这些结果上，两组之间没有差异。两组均未发现膝关节疼痛减轻或性能功能改善。有可能，更强强度的干预或对有更大跌倒风险的膝关节OA患者进行干预，可能会产生敏捷性和扰动训练方法的叠加效应。两个干预组都表现出自我报告功能和整体变化评级的改善。然而，我们的研究结果并不支持敏捷性和扰动训练与标准运动疗法在我们的膝关节OA患者样本中的叠加效应。需要进一步的研究来确定是否有个体亚群可以通过这种方法获得额外的好处。
Background. Impairment-based exercise programs have yielded only small to moderate benefits in reducing pain and improving function in people with knee osteoarthritis (OA). It has previously been proposed that adding agility and perturbation training to exercise programs for people with knee OA may improve treatment effects for pain and function.Objective. The purpose of this study was to examine the effectiveness of adding agility and perturbation techniques to standard exercise therapy compared with the standard exercise program alone for people with knee OA.Design. This was a single-blinded randomized controlled trial.Setting. The study was conducted in the outpatient physical therapy clinic of a large, university-based health center.Participants. One hundred eighty-three people with knee OA (122 women, 61 men) participated.Interventions. Participants were randomly assigned to either a group that received agility and perturbation training with standard exercise therapy or a group that received only the standard exercise program.Measurements. The outcome measures were self-reported knee pain and function, self-reported knee instability, a performance-based measure of function, and global rating of change.Results. Although both groups exhibited improvement in self-reported function and in the global rating of change at the 2-, 6-, and 12-month follow-up periods, there were no differences between groups on these outcomes. There was no reduction in knee pain or improvement in performance-based function in either group.Limitations. It is possible that more-intense application of the interventions or application of the interventions to participants with knee OA who were at greater risk for falling may have yielded additive effects of the agility and perturbation training approach.Conclusions. Both intervention groups exhibited improvement in self-reported function and the global rating of change. Our results, however, did not support an additive effect of agility and perturbation training with standard exercise therapy in our sample of individuals with knee OA. Further study is needed to determine whether there are subgroups of individuals who might achieve an added benefit with this approach.