Establishment of the preventive and therapeutic physical training protocol for osteoarthritis of the knee in middle aged persons.

本研究的目的是通过体育锻炼来治疗轻度膝关节骨性关节炎，以防止恶化。在第一年，我们比较了水上运动和陆地运动的效果。研究对象为中年女性，分为陆上运动组（L组）和水上运动组（W组）。两组膝关节伸展力均显著增加。在足部压力中心（COP）的轨迹和疼痛程度方面，只有W组有明显改善。在W组，没有人退出培训计划。在第二年，我们测试了膝关节支具（动态膝关节支具; DKB）对膝关节OA的影响。DKB可以支持OA受试者继续站立位运动。结果表明，与对照组相比，DKB使COP由内向外移位。这一结果可以证明，解剖对线不良被迫处于正常位置。特别是，一名68岁妇女的受试者可以在没有扶手的情况下楼梯。我们的结论是，DKB在治疗OA，特别是在预防恶化的点上发挥了重要作用。在过去的一年里，我们检查了平衡训练对站立位稳定性的影响。使用Biodex稳定性系统评价稳定性。结果表明，3个月的站立位训练使膝关节稳定性发生了显著变化，因此，我们认为，站立位训练，即水中训练、带支具训练等，可以预防膝关节OA的恶化。

The aim of this study is to treat mild othteoarthritis of the knee by physical trainings for prevention of deterioration.In the first year, we examined effects of water exercise in comparison with land exercise. Subjects were middle aged women and divided into two groups of the land exercise group (the L group) and the water exercise group (the W group). The force of knee extension significantly increased in both groups. Concerning with the trace of the center of pressior (COP) in foot and the degree of pain, significant improvement could be observed only in the W group. In the W group, no one resigned from the training program. Above all, we concluded that the water exercise was effective for mild osteoarthritis of the knee.In the second year, the effect of the knee brace (Dynamic Knee Barance; DKB) on OA of the knee was tested. The DKB could support subjects with OA to continue exercise in the standing position. As a result, DKB made COP shifted from inner to outer position in comparison with the control group. This result can be considerd that the anatomical malalignment was forced to be in a normal position. Especially, one of the subjects of a 68 years old woman could go down stairs without a handrail. We conclude that DKB play an important role in treatment of OA, especially at the point of prevention for deterioration.In the last year, we examined the effect of the balance training on stability in a standing position. Stability was evaluated with the Biodex stability system. As a result, 3 month training made significant change in stability in standing position.Above all, we conclude that exercise in the standing position, i.e. water exercise, exercise with the brace etc, should prevent deterioration of OA of the knee.