{"title":"高频重复经颅磁刺激联合股四头肌力量训练治疗膝骨关节炎的有效性：一项随机对照试验。","authors":"Yifan Wang, Wei Feng, Kun Yang, Yuwu Ding, Bitao Ma, Liming Jiang","doi":"10.1177/1759720X251370979","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Knee osteoarthritis (KOA) is associated with decreased quadriceps strength and decreased activation of central motor cortex. It is necessary to investigate intervention strategies that combine central and peripheral treatments.</p><p><strong>Objective: </strong>To assess the effectiveness of high-frequency repetitive transcranial magnetic stimulation (rTMS) in conjunction with quadriceps strength training for 12 weeks in the treatment of KOA.</p><p><strong>Design: </strong>Prospective, randomized, single-blind, comparative effectiveness study.</p><p><strong>Methods: </strong>In this 12-week randomized controlled clinical trial, 48 eligible patients were randomly allocated to either an experimental group or a control group. The experimental group underwent high-frequency rTMS in conjunction with quadriceps strength training, whereas the control group received sham rTMS alongside quadriceps strength training. The primary outcome measure was the visual analog scale (VAS), while secondary outcome measures included the University of Western Ontario and McMaster University Osteoarthritis Index (WOMAC), the peak torque of the extensor muscles, the peak torque of the flexor muscles, and the flexion-extension ratio. A two-way repeated measures analysis of variance with group as a group factor and time factor was used to calculate the effects of the interventions on all outcome measures.</p><p><strong>Results: </strong>Forty-four of the 48 patients who were allocated at random finished the study. Twelve weeks later, the VAS index in the experimental group decreased from 3.14 ± 1.13 to 1.36 ± 0.85, and that in the control group decreased from 3.23 ± 1.15 to 2.18 ± 1.40 (<i>p</i> < 0.05). At the same time, the WOMAC score, the peak torque of the extensor muscles, the peak torque of the flexor muscles, and the flexion-extension ratio were improved in the two groups (<i>p</i> < 0.05), and the experimental group was significantly better than the control group (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>High-frequency rTMS combined with quadriceps strength training for 12 weeks can effectively improve pain, muscle strength and joint function in patients with KOA.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry (https://www.chictr.org.cn/) ChiCTR2300067617.</p>","PeriodicalId":23056,"journal":{"name":"Therapeutic Advances in Musculoskeletal Disease","volume":"17 ","pages":"1759720X251370979"},"PeriodicalIF":4.1000,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399846/pdf/","citationCount":"0","resultStr":"{\"title\":\"Effectiveness of high-frequency repetitive transcranial magnetic stimulation combined with quadriceps strength training in the treatment of knee osteoarthritis: a randomized controlled trial.\",\"authors\":\"Yifan Wang, Wei Feng, Kun Yang, Yuwu Ding, Bitao Ma, Liming Jiang\",\"doi\":\"10.1177/1759720X251370979\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Knee osteoarthritis (KOA) is associated with decreased quadriceps strength and decreased activation of central motor cortex. It is necessary to investigate intervention strategies that combine central and peripheral treatments.</p><p><strong>Objective: </strong>To assess the effectiveness of high-frequency repetitive transcranial magnetic stimulation (rTMS) in conjunction with quadriceps strength training for 12 weeks in the treatment of KOA.</p><p><strong>Design: </strong>Prospective, randomized, single-blind, comparative effectiveness study.</p><p><strong>Methods: </strong>In this 12-week randomized controlled clinical trial, 48 eligible patients were randomly allocated to either an experimental group or a control group. The experimental group underwent high-frequency rTMS in conjunction with quadriceps strength training, whereas the control group received sham rTMS alongside quadriceps strength training. The primary outcome measure was the visual analog scale (VAS), while secondary outcome measures included the University of Western Ontario and McMaster University Osteoarthritis Index (WOMAC), the peak torque of the extensor muscles, the peak torque of the flexor muscles, and the flexion-extension ratio. A two-way repeated measures analysis of variance with group as a group factor and time factor was used to calculate the effects of the interventions on all outcome measures.</p><p><strong>Results: </strong>Forty-four of the 48 patients who were allocated at random finished the study. Twelve weeks later, the VAS index in the experimental group decreased from 3.14 ± 1.13 to 1.36 ± 0.85, and that in the control group decreased from 3.23 ± 1.15 to 2.18 ± 1.40 (<i>p</i> < 0.05). At the same time, the WOMAC score, the peak torque of the extensor muscles, the peak torque of the flexor muscles, and the flexion-extension ratio were improved in the two groups (<i>p</i> < 0.05), and the experimental group was significantly better than the control group (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>High-frequency rTMS combined with quadriceps strength training for 12 weeks can effectively improve pain, muscle strength and joint function in patients with KOA.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry (https://www.chictr.org.cn/) ChiCTR2300067617.</p>\",\"PeriodicalId\":23056,\"journal\":{\"name\":\"Therapeutic Advances in Musculoskeletal Disease\",\"volume\":\"17 \",\"pages\":\"1759720X251370979\"},\"PeriodicalIF\":4.1000,\"publicationDate\":\"2025-08-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399846/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Therapeutic Advances in Musculoskeletal Disease\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/1759720X251370979\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"RHEUMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Therapeutic Advances in Musculoskeletal Disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/1759720X251370979","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：膝骨关节炎（KOA）与股四头肌力量下降和中央运动皮质激活降低有关。有必要研究中枢和外周治疗相结合的干预策略。目的：评价高频重复经颅磁刺激（rTMS）联合股四头肌力量训练治疗KOA 12周的疗效。设计：前瞻性、随机、单盲、比较疗效研究。方法：在为期12周的随机对照临床试验中，将48例符合条件的患者随机分为实验组和对照组。实验组在进行高频rTMS的同时进行股四头肌力量训练，而对照组在进行伪rTMS的同时进行股四头肌力量训练。主要指标是视觉模拟量表（VAS），次要指标包括西安大略大学和麦克马斯特大学骨关节炎指数（WOMAC）、伸肌峰值扭矩、屈肌峰值扭矩和屈伸比。采用以组为组因素和时间因素的双向重复测量方差分析来计算干预措施对所有结果测量的影响。结果：随机分配的48例患者中有44例完成了研究。12周后，实验组VAS指数由3.14±1.13降至1.36±0.85，对照组VAS指数由3.23±1.15降至2.18±1.40 （p p p p）。结论：高频rTMS联合股四头肌力量训练12周，可有效改善KOA患者的疼痛、肌力和关节功能。试验注册：中国临床试验注册中心（https://www.chictr.org.cn/） ChiCTR2300067617。
Effectiveness of high-frequency repetitive transcranial magnetic stimulation combined with quadriceps strength training in the treatment of knee osteoarthritis: a randomized controlled trial.
Background: Knee osteoarthritis (KOA) is associated with decreased quadriceps strength and decreased activation of central motor cortex. It is necessary to investigate intervention strategies that combine central and peripheral treatments.
Objective: To assess the effectiveness of high-frequency repetitive transcranial magnetic stimulation (rTMS) in conjunction with quadriceps strength training for 12 weeks in the treatment of KOA.
Methods: In this 12-week randomized controlled clinical trial, 48 eligible patients were randomly allocated to either an experimental group or a control group. The experimental group underwent high-frequency rTMS in conjunction with quadriceps strength training, whereas the control group received sham rTMS alongside quadriceps strength training. The primary outcome measure was the visual analog scale (VAS), while secondary outcome measures included the University of Western Ontario and McMaster University Osteoarthritis Index (WOMAC), the peak torque of the extensor muscles, the peak torque of the flexor muscles, and the flexion-extension ratio. A two-way repeated measures analysis of variance with group as a group factor and time factor was used to calculate the effects of the interventions on all outcome measures.
Results: Forty-four of the 48 patients who were allocated at random finished the study. Twelve weeks later, the VAS index in the experimental group decreased from 3.14 ± 1.13 to 1.36 ± 0.85, and that in the control group decreased from 3.23 ± 1.15 to 2.18 ± 1.40 (p < 0.05). At the same time, the WOMAC score, the peak torque of the extensor muscles, the peak torque of the flexor muscles, and the flexion-extension ratio were improved in the two groups (p < 0.05), and the experimental group was significantly better than the control group (p < 0.05).
Conclusion: High-frequency rTMS combined with quadriceps strength training for 12 weeks can effectively improve pain, muscle strength and joint function in patients with KOA.
Trial registration: Chinese Clinical Trial Registry (https://www.chictr.org.cn/) ChiCTR2300067617.
期刊介绍：
Therapeutic Advances in Musculoskeletal Disease delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies across all areas of musculoskeletal disease.
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