UNASSIGNED: The efficacy of treating knee osteoarthritis with hip abductors exercise training combined with repetitive transcranial magnetic stimulation was assessed through functional scales and objective evaluation methods.
UNASSIGNED: In this four-week randomized clinical trial, 160 patients meeting inclusion criteria were randomly assigned 1:1 to group A to receive oral celecoxib and group B to receive a combination of hip abductors exercise training and repeated transcranial magnetic stimulation. The primary outcome was the western Ontario and McMaster universities osteoarthritis index. The secondary outcomes include Visual Analogue Scale, knee outcome survey activities of daily living scale, Active Range of Motion, and the Quadriceps Angle, the tibiofemoral angle, peak adductor moment, the integrated electromyography and root mean square of the surface electromyography of the lower extremity muscles. Paired sample t test was used for Within-Group comparison of outcome indicators, and independent sample t test was used for Between-Group comparison.
UNASSIGNED: Of the 160 randomly assigned patients, 150 completed the study. After 4 weeks, the WOMAC index decreased from 61 ± 10.83 to 40.55 ± 7.58 in the combined treatment group and from 60.97 ± 10.18 to 47.7 ± 10.13 in the celecoxib group. The effect of the combined treatment group was significantly higher than that in the celecoxib group (P< 0.001). In the combined treatment group, the score of knee joint daily living scale increased (P< 0.001), the active range of motion increased (P< 0.001), the quadriceps angle decreased (P< 0.001), the tibiofemoral angle increased (P< 0.001), and the peak adduction moment decreased (P< 0.001), integrated electromyography and root mean square increased (P< 0.001), and the effect was better than that of celecoxib group (P< 0.001). The visual analog scale score in celecoxib group was lower (P< 0.001) and knee outcome survey activities of daily living scale was higher (P< 0.001). The incidence of treatment-related adverse events was 10% in the celecoxib group and 2.5% in the combined treatment group, all of which were mild.
UNASSIGNED: Hip abductors exercise training combined with repetitive transcranial magnetic stimulation can enhance abduction muscle strength, improve mobility, reduce joint pain, and enhance quality of life. This combined approach shows superior clinical effectiveness compared to oral celecoxib.
■通过功能量表和客观评价方法评价髋关节外展肌运动训练联合重复经颅磁刺激治疗膝关节骨性关节炎的疗效。
■在这项为期四周的随机临床试验中,将160例符合纳入标准的患者按1:1随机分为A组接受口服塞来昔布,B组接受髋关节外展器运动训练和重复经颅磁刺激的组合。主要结果是西部安大略省和麦克马斯特大学的骨关节炎指数。次要结果包括视觉模拟量表,膝关节结果调查日常生活活动量表,活动范围,和股四头肌角度,胫骨股角度,峰值内收力矩,综合肌电图和下肢肌肉表面肌电图均方根。结果指标的组内比较采用配对样本t检验,组间比较采用独立样本t检验。
■在随机分配的160名患者中,150人完成了这项研究。4周后,联合治疗组WOMAC指数从61±10.83降至40.55±7.58,塞来昔布组从60.97±10.18降至47.7±10.13.联合医治组疗效明显高于塞来昔布组(P<0.001)。在联合治疗组中,膝关节日常生活量表评分提高(P<0.001),活动范围增加(P<0.001),股四头肌角度减小(P<0.001),胫股角增大(P<0.001),峰值内收力矩减小(P<0.001),综合肌电图和均方根增加(P<0.001),疗效优于塞来昔布组(P<0.001)。塞来昔布组的视觉模拟评分较低(P<0.001),膝关节日常生活活动能力量表较高(P<0.001)。塞来昔布组治疗相关不良事件发生率为10%,联合治疗组为2.5%,所有这些都是温和的。
■髋关节外展肌运动训练结合重复经颅磁刺激可增强外展肌力量,提高流动性,减少关节疼痛,提高生活质量。与口服塞来昔布相比,这种联合方法显示出更高的临床疗效。