Objective:To observe the clinical efficacy of sitting-position knee adjustment Tuina(Chinese therapeutic massage)and therapeutic ultrasound in treating knee osteoarthritis(KOA)and the impact on gait analysis parameter...Objective:To observe the clinical efficacy of sitting-position knee adjustment Tuina(Chinese therapeutic massage)and therapeutic ultrasound in treating knee osteoarthritis(KOA)and the impact on gait analysis parameters.Methods:In a randomized controlled design,80 KOA patients were randomly allocated to a manipulation group and an ultrasound group,each with 40 cases.Patients in the manipulation group received the sitting-position knee adjustment Tuina treatment;patients in the ultrasound group received low-frequency ultrasounds for treatment.The intervention was conducted twice weekly,and therapeutic efficacy was evaluated after 4 weeks of treatment.Before treatment,immediately after treatment,and after 2-week and 4-week treatment,the visual analog scale(VAS)and the Western Ontario and McMaster Universities osteoarthritis index(WOMAC)scores were observed;the gait analysis outcomes were compared before treatment and after 4-week treatment,including cadence,speed,step length,stride length,single stance phase,double stance phase,and the maximal flexion angle of the knee joint.Results:Intra-group comparisons revealed that both groups showed decreased VAS scores and increased WOMAC scores immediately after treatment and after 2-week and 4-week treatment,with statistical significance(P<0.05).Immediately after treatment,the VAS score was lower in the manipulation group than in the ultrasound group(P<0.05),and the WOMAC pain score was higher in the manipulation group(P<0.05),while the ultrasound group had a higher WOMAC stiffness score than the manipulation group(P<0.05).After 2 weeks of treatment,there were no significant differences in VAS and WOMAC scores between the two groups(P>0.05).After 4-week treatment,the ultrasound group had a higher WOMAC pain score than the manipulation group(P<0.05),and the manipulation group had higher WOMAC stiffness and function scores than the ultrasound group(P<0.05).The between-group difference in the WOMAC total score remained statistically insignificant throughout the treatment(P>0.05).Regarding the gait parameters,both groups showed improvements in the cadence,speed,step length,stride length,single stance phase,double stance phase,swing phase,and maximal knee flexion angle immediately after treatment and after 2 and 4 weeks of treatment;the intra-group differences were all statistically significant(P<0.05).After 4-week treatment,the manipulation group surpassed the ultrasound group in improvements in stride length,step length,swing phase,single stance phase,and maximal knee flexion angle(P<0.05).Conclusion:Both the sitting-position knee adjustment Tuina and low-frequency ultrasound therapies are effective in treating KOA and can improve the patient’s walking ability;the sitting-position knee adjustment manipulation demonstrates superior immediate pain relief and long-term improvement of stiffness,joint function,and walking ability compared to the low-frequency ultrasound.展开更多
基金supported by Shanghai Key Clinical Specialty Project(上海市临床重点专科项目,No.shslczdzk04001)High-level Key Discipline of National Administration of Traditional Chinese Medicine-Tuina Science(国家中医药管理局高水平重点学科-推拿学,No.zyyzdxk-2023061)The 10th Batch of Talent Cultivation Project Under the“Young Talents Program”of Yueyang Hospital(岳阳医院第十批青苗计划人才培养项目,No.RY411.07.02.23).
文摘Objective:To observe the clinical efficacy of sitting-position knee adjustment Tuina(Chinese therapeutic massage)and therapeutic ultrasound in treating knee osteoarthritis(KOA)and the impact on gait analysis parameters.Methods:In a randomized controlled design,80 KOA patients were randomly allocated to a manipulation group and an ultrasound group,each with 40 cases.Patients in the manipulation group received the sitting-position knee adjustment Tuina treatment;patients in the ultrasound group received low-frequency ultrasounds for treatment.The intervention was conducted twice weekly,and therapeutic efficacy was evaluated after 4 weeks of treatment.Before treatment,immediately after treatment,and after 2-week and 4-week treatment,the visual analog scale(VAS)and the Western Ontario and McMaster Universities osteoarthritis index(WOMAC)scores were observed;the gait analysis outcomes were compared before treatment and after 4-week treatment,including cadence,speed,step length,stride length,single stance phase,double stance phase,and the maximal flexion angle of the knee joint.Results:Intra-group comparisons revealed that both groups showed decreased VAS scores and increased WOMAC scores immediately after treatment and after 2-week and 4-week treatment,with statistical significance(P<0.05).Immediately after treatment,the VAS score was lower in the manipulation group than in the ultrasound group(P<0.05),and the WOMAC pain score was higher in the manipulation group(P<0.05),while the ultrasound group had a higher WOMAC stiffness score than the manipulation group(P<0.05).After 2 weeks of treatment,there were no significant differences in VAS and WOMAC scores between the two groups(P>0.05).After 4-week treatment,the ultrasound group had a higher WOMAC pain score than the manipulation group(P<0.05),and the manipulation group had higher WOMAC stiffness and function scores than the ultrasound group(P<0.05).The between-group difference in the WOMAC total score remained statistically insignificant throughout the treatment(P>0.05).Regarding the gait parameters,both groups showed improvements in the cadence,speed,step length,stride length,single stance phase,double stance phase,swing phase,and maximal knee flexion angle immediately after treatment and after 2 and 4 weeks of treatment;the intra-group differences were all statistically significant(P<0.05).After 4-week treatment,the manipulation group surpassed the ultrasound group in improvements in stride length,step length,swing phase,single stance phase,and maximal knee flexion angle(P<0.05).Conclusion:Both the sitting-position knee adjustment Tuina and low-frequency ultrasound therapies are effective in treating KOA and can improve the patient’s walking ability;the sitting-position knee adjustment manipulation demonstrates superior immediate pain relief and long-term improvement of stiffness,joint function,and walking ability compared to the low-frequency ultrasound.
