训练方式和额外的疼痛教育对膝关节骨关节炎患者运动性痛觉减退的影响：一项随机对照可行性试验。

IF 3.4 2区医学 Q1 ANESTHESIOLOGY

European Journal of Pain Pub Date : 2025-10-03 DOI:10.1002/ejp.70141

Marie-Sofie Anderheide, Jana Szargiej, Katja Ehrenbrusthoff, Michael Schuler, Christian Thiel

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引用次数: 0

摘要

背景：这项随机对照可行性研究旨在评估一项主要研究的可行性，并首次评估膝关节骨关节炎（OA）患者的运动性痛觉减退（EIH）反应是否因训练方式而异，以及是否可以通过疼痛教育来增强。方法：将膝关节OA患者（n = 36, 60±11岁，WOMAC总人数51.7±36.6）随机分为下体阻力训练（RTL）、上体阻力训练（RTU）和有氧训练（AET）三组。每位参与者进行了三次训练（t1, t2, t3），间隔1周，并在t2后进行了疼痛和EIH教育。在每次训练前（PPT0）、训练后（PPT1）和训练后30分钟（PPT30）测量6个部位的压痛阈值（PPT）。使用实用性、可接受性和安全性指标评估可行性。结果：本研究的程序被认为是可行的，包括测量方法和教育信息的高接受度，训练练习的耐受性良好，辍学率为8%。在每组和每次治疗后，可在PPT1和PPT30检测到EIH反应（Cohen's d≥0.5至≥0.8）。在大多数测量点，效应量往往在RTL后和t3时最大。结论：有必要进行更大规模的研究。RTL、AET和RTU均可诱发膝关节炎患者的EIH。疼痛教育可能有一个有用的辅助功能，但它的效果需要在研究设计中确定，使用一个接受培训而不接受教育的对照组。意义说明：下体阻力训练，以及有氧训练和上体阻力训练都可能导致膝关节骨关节炎患者痛觉减退。在进行各种运动训练方式后，减轻疼痛敏感性提供了显着的益处，并可以改善膝关节OA患者的生活质量。如果在更大规模的研究中得到证实，这些发现也可以更好地考虑患者的个人偏好和潜在的运动处方合并症。试验注册：德国临床试验注册：DRKS00024480。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Effects of Training Modalities and Additional Pain Education on Exercise-Induced Hypoalgesia in People With Osteoarthritis of the Knee: A Randomised Controlled Feasibility Trial

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Effects of Training Modalities and Additional Pain Education on Exercise-Induced Hypoalgesia in People With Osteoarthritis of the Knee: A Randomised Controlled Feasibility Trial

Background

This randomised controlled feasibility study aimed to evaluate the feasibility of a main study and provide a first assessment of whether the exercise-induced hypoalgesia (EIH) response differs depending on the training modalities in people with knee osteoarthritis (OA) and whether it can be enhanced by education about pain.

Methods

People with knee OA (n = 36, 60 ± 11 years, WOMAC total 51.7 ± 36.6) were randomly assigned to receive lower body resistance training (RTL), upper body resistance training (RTU), or aerobic training (AET). Each participant performed three training sessions (t1, t2, t3) separated by 1 week, and education about pain and EIH after t2. Pressure pain threshold (PPT) was measured at six sites before (PPT0), immediately after (PPT1), and 30 min after (PPT30) each training session. Feasibility was assessed using indicators for practicability, acceptance, and safety.

Results

This study's procedures were deemed feasible, including high acceptance of the measurement method and educational information, well-tolerated training exercises, and a dropout rate of 8%. In each group and after each session, an EIH response could be detected at PPT1 and PPT30 (Cohen's d ≥ 0.5 to ≥ 0.8). At most measurement sites, effect sizes tended to be largest after RTL and at t3.

Conclusion

Progression to a larger study is warranted. RTL, but also AET and RTU may induce EIH in people with knee OA. Pain education might have a useful supporting function, but its effect would need to be determined in a study design using a control group that receives training and no education.

Significance Statement

Lower body resistance training, but also aerobic training and upper body resistance training may induce hypoalgesia in people with knee osteoarthritis. Being less pain sensitive after performing various exercise training modalities provides a significant benefit and can improve the quality of life of people with knee OA. If confirmed in a larger study, these findings might also allow better consideration of patients' individual preferences and potential comorbidities for exercise prescription.

Trial Registration

German Clinical Trials Register: DRKS00024480

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来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.