体外冲击波联合振动训练对膝骨关节炎疗效的影响

关键词：运动康复  中老年人  全身振动训练  体外冲击波  膝骨关节炎  疼痛

Keywords:sports rehabilitation  middle-aged and elderly adults  whole-body vibration training  extracorporeal shock wave  knee osteoarthritis  pain

摘要：

      摘要 目的：探讨体外冲击波联合振动训练对早中期膝骨关节炎患者的临床疗效。 方法：纳入120例早中期膝骨关节炎患者，通过随机数字表法分为振动训练组、冲击波组、联合干预组，治疗周期为8周。采用WOMAC评分、VAS疼痛评分、Lysholm膝关节评分、膝关节活动度和炎症及基质酶指标作为结局指标，分别于治疗前、治疗8周进行评估，并在治疗12周、20周随访。 结果：三组患者治疗后各项指标均较治疗前显著改善（P<0.05），且联合干预组在WOMAC评分、VAS评分、Lysholm评分、膝关节活动度及炎症与基质酶指标的改善程度上均显著优于振动训练组与冲击波组，差异具有显著性意义（P<0.01）。12周随访和20周随访时，除振动训练组的膝关节活动度较治疗前变化无显著性意义（P>0.05），其余指标均显著改善（P<0.01）；冲击波组在20周随访时，除膝关节活动度较治疗前变化无显著性意义（P>0.05），其余指标均显著改善（P<0.01）。 结论：体外冲击波联合振动训练能够显著减轻早中期膝骨关节炎患者的局部炎症水平和疼痛程度，改善关节活动度和功能。

Abstract:

      Abstract Objective： To investigate the clinical efficacy of extracorporeal shock wave therapy combined with the whole-body vibration training in patients with early- to mid-stage knee osteoarthritis. Method： A total of 120 patients with early to moderate knee osteoarthritis were enrolled and randomly divided into a vibration group， a shock wave group， and a combination group using a random number table. The combination group received whole-body vibration training combined with extracorporeal shock wave therapy， the shock wave group received extracorporeal shock wave therapy alone， and the vibration group received vibration training alone. The treatment duration was 8 weeks. Outcome measures included Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)， visual analogue scale(VAS)， Lysholm knee scores， knee joint range of motion （ROM）， and inflammatory and matrix enzyme biomarkers. Assessments were conducted at baseline， immediately after 8 weeks of treatment， and at 12-week and 20-week follow-ups post-treatment. Result： After treatment, all three groups showed significant improvements in all outcome measures compared to baseline（P<0.05）. Furthermore， the combination group demonstrated significantly greater improvements in WOMAC score， VAS score， Lysholm score， knee range of motion， and levels of inflammatory and matrix enzymes than both the vibration training group and the shock wave group （P<0.01）. At the 12-week and 20-week follow-ups， all outcome measures remained significantly improved compared to baseline（P<0.01）, except for Knee ROM in the vibration training group， which showed no significant change from baseline （P>0.05）. In the shock wave group, knee ROM also showed no significant improvement at the 20-week follow-up (P>0.05), whereas all other indicators remained significantly improved (P<0.01). Conclusion： Extracorporeal shock wave therapy combined with whole-body vibration training significantly alleviates local inflammation and pain, and improves joint mobility and function in patients with early- to mid-stage knee osteoarthritis.