Mr Alexandre Kovats, Mr Adrian Ram, Matthew D Jones, A/Prof John Booth, Dr Mitchell T. Gibbs, A/Prof Jeanette Thom
{"title":"膝关节骨性关节炎患者的疼痛性运动与非疼痛性运动对crepitus的影响:混合方法分析","authors":"Mr Alexandre Kovats, Mr Adrian Ram, Matthew D Jones, A/Prof John Booth, Dr Mitchell T. Gibbs, A/Prof Jeanette Thom","doi":"10.31189/2165-7629-13-s2.477","DOIUrl":null,"url":null,"abstract":"\n \n Crepitus (or physiological noise) is a key criterion in the diagnosis of knee osteoarthritis (OA). Exercise is foundational to guideline-based care for knee OA, however the effect exercise on knee crepitus is unknown. This study aimed to explore the perceptions of people with knee OA following a 6-week accredited exercise physiologist (AEP) led intervention involving painful vs non-painful exercise, especially in relation to their knee crepitus.\n \n \n \n Participants were randomly assigned to either a painful (higher intensity) or non-painful (lower intensity) exercise program supervised by an AEP twice a week for six weeks with concurrent education. Volunteers partook in a post-intervention semi-structured interview with questions surrounding their experience and perceived outcomes of the program. Thematic qualitative analysis was conducted and compared to the Knee Injury and Osteoarthritis Outcome Score (KOOS) crepitus question (0 - 4 scale).\n \n \n \n Eleven participants volunteered. Qualitatively, approximately half of the participants self-reported a decrease in their knee crepitus following the program “I haven’t had the creaky knees so much”, with the rest stating their crepitus did not change. No participants perceived their crepitus increased (n=9 no change, n=2 decreased) or said that their crepitus was worse, “the noise and grinding doesn’t become evident (now) until the weights become higher”. Quantitatively, KOOS crepitus scores also did not change following the intervention [mean (SD) (2.4(1.0) to 2.1(1.3), p=0.19)]. 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Gibbs, A/Prof Jeanette Thom\",\"doi\":\"10.31189/2165-7629-13-s2.477\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"\\n \\n Crepitus (or physiological noise) is a key criterion in the diagnosis of knee osteoarthritis (OA). Exercise is foundational to guideline-based care for knee OA, however the effect exercise on knee crepitus is unknown. This study aimed to explore the perceptions of people with knee OA following a 6-week accredited exercise physiologist (AEP) led intervention involving painful vs non-painful exercise, especially in relation to their knee crepitus.\\n \\n \\n \\n Participants were randomly assigned to either a painful (higher intensity) or non-painful (lower intensity) exercise program supervised by an AEP twice a week for six weeks with concurrent education. Volunteers partook in a post-intervention semi-structured interview with questions surrounding their experience and perceived outcomes of the program. 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引用次数: 0
摘要
吱吱声(或生理噪音)是诊断膝关节骨性关节炎(OA)的一个重要标准。运动是膝关节 OA 指导性治疗的基础,但运动对膝关节褶皱的影响尚不清楚。本研究旨在探讨膝关节OA患者在接受为期6周的由认证运动生理学家(AEP)主导的疼痛与非疼痛运动干预后的感受,尤其是与膝关节皱褶有关的感受。 参与者被随机分配到一个痛苦(较高强度)或非痛苦(较低强度)的运动项目中,该项目由一名运动生理学家指导,每周两次,为期六周,并同时进行教育。志愿者参加了干预后的半结构式访谈,问题围绕他们的经历和对项目成果的感知。我们进行了专题定性分析,并将其与膝关节损伤和骨关节炎结果评分(KOOS)的皱褶问题(0 - 4 级)进行了比较。 有 11 名参与者自愿参加。从定性角度来看,约有一半的参与者自称参加该计划后膝关节褶皱减少了,"我的膝盖不再那么嘎吱作响了",其余的人则表示他们的褶皱没有变化。没有参与者认为膝关节疼痛加剧(9 人无变化,2 人减轻),也没有参与者表示膝关节疼痛加剧,"(现在)直到负重增加,疼痛和磨擦才会明显减轻"。从数量上看,KOOS 痉挛评分在干预后也没有变化[平均值(标清)(2.4(1.0) 至 2.1(1.3),P=0.19)]。在自我感觉的疼痛结果方面,各运动组之间没有差异,大多数人都表示运动项目是有益的,"在整个项目结束后,我发现我可以更轻松地活动了"。 较高强度的运动(达到疼痛范围)并不会改变某些人的皱褶感,或者可能会有所改善。有 OA 的人认为高强度和低强度的运动都是有益和愉快的。
PAINFUL VS NON-PAINFUL EXERCISE ON CREPITUS IN PEOPLE WITH KNEE OSTEOARTHRITIS: A MIXED-METHODS ANALYSIS
Crepitus (or physiological noise) is a key criterion in the diagnosis of knee osteoarthritis (OA). Exercise is foundational to guideline-based care for knee OA, however the effect exercise on knee crepitus is unknown. This study aimed to explore the perceptions of people with knee OA following a 6-week accredited exercise physiologist (AEP) led intervention involving painful vs non-painful exercise, especially in relation to their knee crepitus.
Participants were randomly assigned to either a painful (higher intensity) or non-painful (lower intensity) exercise program supervised by an AEP twice a week for six weeks with concurrent education. Volunteers partook in a post-intervention semi-structured interview with questions surrounding their experience and perceived outcomes of the program. Thematic qualitative analysis was conducted and compared to the Knee Injury and Osteoarthritis Outcome Score (KOOS) crepitus question (0 - 4 scale).
Eleven participants volunteered. Qualitatively, approximately half of the participants self-reported a decrease in their knee crepitus following the program “I haven’t had the creaky knees so much”, with the rest stating their crepitus did not change. No participants perceived their crepitus increased (n=9 no change, n=2 decreased) or said that their crepitus was worse, “the noise and grinding doesn’t become evident (now) until the weights become higher”. Quantitatively, KOOS crepitus scores also did not change following the intervention [mean (SD) (2.4(1.0) to 2.1(1.3), p=0.19)]. There were no differences between exercise groups in self-perceived crepitus results, and most said that the exercise program was beneficial “Right after this whole program, I find that I can move much easier.”
Exercise at higher intensities (into painful range) does not change crepitus or may improve it for some. People with OA perceive that exercise at both higher and lower intensity is beneficial and enjoyable.