Postural correction training improves chronic pain, nerve function, and inflammation in knee osteoarthritis: A retrospective cohort study.

Background: Knee osteoarthritis (KOA) is a prevalent degenerative joint disorder characterized by complex neuroinflammatory mechanisms involving peripheral-central nervous system crosstalk. Current research gaps exist regarding the modulatory effects of biomechanical interventions such as postural correction training (PCT) on these pathways, particularly its impact on neurogenic inflammation and associated nerve dysfunction.

Aim: To examine the effect of PCT on chronic pain related to KOA, nerve function, and inflammatory factors and further assess the influencing factors.

Methods: This study included 100 patients with chronic pain related to KOA admitted to our hospital from March 2022 to March 2024 who were selected as research subjects, and divided into a control group (conventional treatment, n = 50) and observation group (combined treatment with PCT, n = 50). Efficacy, pain [visual analog scale (VAS)], nerve function [the National Institute of Health Stroke Scale (NIHSS)] and inflammatory factors [interleukin (IL)-1β, IL-6, tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP)] were assessed and compared. Moreover, the factors influencing efficacy were assessed according to clinical efficacy.

Results: The clinical effectiveness rate of 90.00% in the observation group was higher than that of 72.00% in the control group (P < 0.05). VAS scores at 14 and 30 days of the intervention were lower than those before the intervention (P < 0.05). Moreover, VAS scores in the observation group at 14 and 30 days after the intervention were lower than those in the control group (P < 0.05). The NIHSS scores were lower after the intervention than those before the intervention for both groups (P < 0.05). The improvement in NIHSS score in the observation group was higher than that in the control group (P < 0.05). Inflammatory factors such as IL-1β, IL-6, TNF-α, and CRP in both groups among patients with osteoarthritis-related chronic pain were lower after the intervention than before the intervention (P < 0.05). After the intervention, all inflammatory factors in the observation group were lower than those in the control group (P < 0.05). The proportion of ineffective treatment combined with joint effusion, Kellgren-Lawrence (K-L) staging grade III-IV, fixed flexion contracture with varus and valgus deformity > 5°, was higher in the control group than in the observation group (P < 0.05), while the joint compartment involvement in the observation group was higher than that in the control group (P < 0.05). The logistic regression results demonstrated that relevant joint effusion, K-L staging grade III-IV, fixed flexion contracture with varus and valgus deformity > 5°, and intervention mode of PCT were higher in the control group than in the observation group (P < 0.05) and were influencing factors on clinically ineffective treatment (P < 0.05).

Conclusion: PCT can improve the treatment effect on chronic pain related to KOA, nerve function and inflammatory response. Joint effusion, joint stiffness, and KOA are factors for y ineffective treatment. Joint effusion, higher K-L stage, and larger flexion contracture were risk factors, while PCT was a protective factor for ineffective treatment.