水中步行训练对膝关节骨性关节炎患者功能恢复的影响

目的观察水中步行训练对膝关节骨性关节炎（KOA）患者的疗效。方法将40例KOA患者随机分为观察组与对照组。两组患者均给予常规康复治疗，包括物理因子治疗、关节功能训练及下肢肌力训练等。观察组加用水中步行训练，连续治疗8周。两组患者分别在治疗前、治疗后进行视觉模拟评分法（VAS）评分、西安大略大学及麦克马斯特大学骨关节炎指数（WOMAC）评分、膝关节功能评分（HSS评分）、本体感觉测试及日常生活能力评定（MBI评分）。结果经治疗8周后，两组患者的VAS评分、WOMAC评分、HSS评分、MBI评分均有所改善，与对照组比较，观察组患者VAS评分、WOMAC评分明显下降（V〈0．01），HSS评分及MBI评分明显提高（P〈0．01），患膝关节主动复位误差角度值明显小于对照组差异有统计学意义（P〈0．01）。结论对于KOA患者，水中步行训练的应用可更好的提高膝关节的稳定性及本体感觉，改善患者临床症状及日常生活能力。

Objective To investigate the effects of underwater treadmill training in patients with osteoarthritis of knee （ KOA ） . Methods Forty KOA patients were randomly divided into control group （ n=20 ） and treated group （ n=20 ） .Two groups accepted routine therapy. Treated group was given underwater treadmill training for 8 weeks.All patients with KOA were assessed with the VAS score, the Western Ontario and McMaster University Osteoarthritis index （ WOMAC ） score, the Hospital for Special Surgery knee rating scale （ HSS ） , proprioceptive function and modified Barthel index （ MBI ） before treatment and 8 weeks later. Results After 8 weeks treatment, the results showed the treated group had significant improvements in HSS scores, active reposition sense and MBI compared to control group （ P〈0.01 ） . In the VAS score and WOMAC score, the treated group had significant decline compared to control group （ P〈0.01 ） . Conclusion Underwater treadmill training on patients with osteoarthritis of knee is significantly more effective than conventional rehabilitation alone in alleviating the clinical symptom, improving stability of knee, proprioceptiun and activities of daily living.