基于微信的居家运动干预在老年膝关节骨关节炎患者中的应用效果

Effects of WeChat-based home exercise intervention in elderly patients with knee osteoarthritis

目的探讨基于微信实施居家运动干预对老年膝关节骨关节炎(KOA)患者康复效果的影响。方法于2019年8月—2020年1月进行为期24周的类实验研究。采用便利抽样法抽取北京市海淀区6个社区,以社区为单位使用信封法进行随机分组,干预组和对照组各3个社区。干预组患者(n=46)给予基于微信的居家运动干预(包括知识讲解、运动技能传授、行为激励),对照组患者(n=43)给予基于微信的知识讲解。收集两组患者第0、8、24周客观膝关节功能(包括下肢肌力、膝关节活动范围、平衡功能和移动能力)和主观KOA症状(包括疼痛、僵硬、日常活动难度)指标。结果干预24周内,两组老年KOA患者双侧下肢肌力均随时间变化而增强,干预组改善幅度优于对照组,差异有统计学意义(P<0.05)。干预后第8、24周,干预组患者膝关节活动范围改善幅度优于对照组,差异有统计学意义(P<0.05)。干预24周内,两组老年KOA患者平衡功能均随时间变化而增强,干预组改善幅度优于对照组,差异有统计学意义(P<0.05)。干预24周内,两组老年KOA患者移动能力均随时间变化而增强,但干预组只有第8周移动能力优于对照组,差异有统计学意义(P<0.05)。除第24周两组进行日常活动难度维度得分外,干预期间两组患者西安大略和麦克马斯特大学骨关节炎指数(WOMAC)总分、疼痛维度、僵硬维度、日常活动难度维度得分在第8、24周比较差异均无统计学意义(P>0.05)。结论基于微信的居家运动干预能改善老年KOA患者下肢肌力、膝关节活动范围、平衡功能和移动能力等客观膝关节功能,但对患者的主观症状影响不明显。

Objective To explore the effects of WeChat-based home exercise intervention on the rehabilitation of elderly patients with knee osteoarthritis(KOA).Methods A 24-week quasi-experimental research was conducted from August 2019 to January 2020.Totally 6 communities were selected from Haidian District,Beijing by convenient sampling and randomly divided into the control group(n=3)and the observation group(n=3)using the envelope method.Patients in the intervention group(n=46)were received WeChat-based home exercise intervention(including knowledge explanation,exercise skill education,and behavioral motivation),while patients in the control group(n=43)received WeChat-based knowledge explanation.The objective knee function(including muscle strength of lower limbs,range of motion of knee joints,balance function,and mobility)and subjective KOA symptoms(including pain,stiffness,and difficulty in daily activities)were collected from the two groups of patients at 0,8th,and 24th weeks.Results Within 24 weeks of intervention,the muscle strength of both lower limbs of the two groups increased with time,and the improvement in the intervention group was better than that in the control group,and the difference was statistically significant(P<0.05).At the 8th and 24th weeks after intervention,the range of motion of knee joints in the intervention group improved better than the control group,and the differences were statistically significant(P<0.05).Within 24 weeks of intervention,the balance function of the two groups improved with time,and the improvement of the intervention group was better than that of the control group,and the difference was statistically significant(P<0.05).Within 24 weeks of intervention,the mobility of the two groups increased with time,but the intervention group had better mobility than the control group only in the 8th week,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the total scores of the Western Ontario and McMaster University Osteoarthritis Index(WOMAC)and scores of pain,stiffness,and difficulty in daily activities between the two groups in the 8th and 24th weeks(P>0.05),except the difficulty in daily activities between the two groups in the 24th week.Conclusions WeChat-based home exercise intervention can improve the objective knee joint functions of elderly KOA patients,such as muscle strength of lower limbs,range of motion of knee joints,balance function and mobility,but it has no obvious effect on the subjective symptoms of patients.