全身振动训练对膝骨关节炎有效性的随机对照研究

Effectiveness of whole body vibration therapy on knee osteoarthritis: a randomized controlled study

目的探讨全身振动训练（WBVT）对膝骨关节炎（KOA）患者疼痛、下肢肌力、肌肉状态及功能表现的有效性。方法选择2013年10月至2014年10月于南京大学医学院附属鼓楼医院康复医学科门诊治疗的KOA患者40例,其中男性20例,女性20例;年龄50~65岁,平均年龄57.35岁。以1∶1比例按随机数字进入WBVT组和对照组,每组20例,男女例数相同,WBVT组采用传统治疗＋多频振动仪干预,对照组仅采用传统治疗。疼痛采用视觉模拟量表（VAS）评分,下肢肌力采用徒手肌力评定法（MRC分级法）,肌肉状态采用Myoton-3设备检测,膝关节功能状态采用WOMAC评定。干预时间为1个月。结果组间基线一致。干预1个月后,WBVT组肌力和肌肉状态有提升,与对照组相比,差异有统计学意义[t（MMT）=6.07,t（Freq）=3.43,t（Stiff）=2.79,t（Decr）=8.97,P〈0.05];VAS和WOMAC数值两组均有下降趋势,WBVT组与对照组相比,差异有统计学意义[t（VAS）=3.19,t（WOMAC）=2.26,P〈0.05]。结论 WBVT可以减轻KOA患者疼痛,提高股四头肌肌力,改善肌肉状态和膝关节功能,是一种可推荐的治疗方式。

Objective To evaluate the effect of whole body vibration therapy（WBVT） on pain, lower limb muscle Strength, muscle status and functional performance of patients with knee osteoarthritis（KOA）. Methods From October 2013 to October 2014, a total of 40 KOA patients were enrolled, which included 20 males and 20 females, aged 50 - 65 years old with mean age of 57.35 years old. All of them were randomized divided into WBVT group and control group with 1 ： 1 ratio. The WBVT group was treated by multi frequency vibration instrument based on traditional therapy, and control group was treated only by traditional therapy. Pain was evaluated by visual analogue scale （VAS）. The lower limb muscle strength was judged by manual muscle assessment（MRC grading method）. The muscle status recorded with Myoton-3 device detection and Western Ontario and McMaster Universities（WOMAC） was used to assess state of knee function. The intervention time lasted 1-month. Results The baseline was consistent between 2 groups. Compared with control group, muscle strength and muscle status in WBVT group were increased after intervention 1-month, the difference was significant [t （MMT） = 6.07, t （Frect）= 3.43, t（Stiff） = 2.79, t （Deer） = 8.97, P 〈 0.05]; the numerical value of VAS and WOMAC of 2 groups showed declining trend. There was statistically significant difference between 2 groups[t（VAS） = 3.19, t（WOMAC） = 2.26, P 〈 0.05]. Conclusion It is demonstrated that WBVT could reduce pain and improve muscle strength of quadriceps, improve muscle status and function of knee joint in KOA patients, so WBVT is the recommended treatment method.