太极推手干预中老年人膝骨关节炎的效果研究

Study on the Effect of Tai Chi Pushing Hand Intervention on Middle and Elderly Patients with Knee Osteoarthritis

目的:探讨太极推手运动对膝骨关节炎(KOA)的干预效果。方法:通过社区招募50名KOA患者,随机分为对照组(N1=25)和推手组(N2=25)。对照组给予无监督的KOA居家运动康复指导;推手组给予以太极推手运动为主体的康复训练,每周训练3次,每次90min。干预前和干预12周后分别采集两组患者疼痛视觉模拟评分(VAS)、Lysholm膝关节功能评分、下肢力量、Y平衡测试(YBT)和抑郁-焦虑-压力量表(DASS-21)评分的测试数据,并使用重复测量的双因素方差分析等方法对测试数据进行统计学分析。结果:干预前,对照组和推手组各项指标均无统计学差异。干预12周后,进行对照组和推手组的组间比较,显示与对照组相比,推手组在VAS、Lysholm评分和YBT测试结果上具有显著差异(P<0.001),在下肢力量和DASS-21量表三个维度的前后比较中,差异有统计学意义(P<0.05);干预12周后,对照组的组内比较显示,对照组各项指标前后差异均无统计学意义(P>0.05);推手组的组内比较显示,推手组VAS、Lysholm评分、下肢力量和YBT测试的结果均显著优于干预前(P<0.001),在DASS-21量表抑郁、焦虑和压力三个维度的评分低于干预前,差异有统计学意义(P<0.05)。结论:太极推手运动干预方案能够减轻KOA患者膝关节疼痛,改善膝关节功能,提高动态平衡能力,并提升患者心理健康水平。

Objective:To explore the intervention effect of Tai Chi push hand(TCPH)exercise on knee osteoarthritis(KOA).Method:50 KOA patients were recruited from the community and randomly divided into control group(N1=25)and TCPH group(N2=25).The control group received unsupervised exercise rehabilitation guidance;TCPH group received rehabilitation training mainly focused on Tai Chi Pushing Hands,with 3 sessions per week for 90 minutes each time.Before and after 12 weeks of intervention,test data were collected from two groups of patients for pain visual analogue scale(VAS),Lysholm knee score scale(LKSS),lower limb strength,Y-balance test(YBT),and Depression Anxiety and Stress Scale(DASS-21).Result:Before intervention,there was no statistical difference in all indicators between the control group and the TCPH group.After 12 weeks of intervention,there was no statistically significant difference in all indicators before and after the control group(P>0.05).The VAS,LKSS,lower limb strength,and YBT results of the TCPH group were significantly better than before the intervention(P<0.001).The scores of depression,anxiety,and stress on the DASS-21 scale were lower than before the intervention,and the difference was statistically significant(P<0.05);After 12 weeks of intervention,compared with the control group,the TCPH group showed significant differences in VAS,LKSS,and YBT results(P<0.001);There was a statistically significant difference in the comparison of lower limb strength and the three dimensions of the DASS-21before and after(P<0.05).Conclusion:The Tai Chi Pushing Hand Exercise Program can reduce the degree of knee joint pain,improve knee joint function,dynamic balance,and mental health in patients with knee osteoarthritis.