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AIM:改良的鞋子是否为膝关节骨性关节炎患者带来额外的益处?

2016-07-12 MedSci MedSci原创

合适的鞋类被建议用于对膝关节骨性关节炎的自我管理。减少有害膝盖负荷的鞋是可用的,但对症状的影响是不确定的。该研究的目的是评估卸载鞋在缓解膝关节骨性关节炎症状的功效。研究人员进行了一项参与者和评估者双盲的疗效比较的随机,对照试验。该研究在社区进行。共涉及164例膝关节骨性关节炎患者。参与者穿着三重密度步行鞋,该步行鞋有可变刚度中底和温和的横向楔形鞋垫设计,卸载膝内侧负担,每天穿着(干预组),与传统的

合适的鞋类被建议用于对膝关节骨性关节炎的自我管理。减少有害膝盖负荷的鞋是可用的,但对症状的影响是不确定的。

该研究的目的是评估卸载鞋在缓解膝关节骨性关节炎症状的功效。

研究人员进行了一项参与者和评估者双盲的疗效比较的随机对照试验。该研究在社区进行。共涉及164例膝关节骨性关节炎患者。

参与者穿着三重密度步行鞋,该步行鞋有可变刚度中底和温和的横向楔形鞋垫设计,卸载膝内侧负担,每天穿着(干预组),与传统的步行鞋进行了比较(比较组)。

主要结局是在6个月时行走疼痛(使用数字评估法[NRS])和物理功能(西安大略和麦克马斯特大学骨关节炎指数[WOMAC])。次要终点是膝关节疼痛和僵硬(WOMAC),平均疼痛(NRS),间歇性和持续性膝关节疼痛(间歇性和持续的骨关节炎疼痛问卷),生活质量(生活质量评估),体力活动(针对老年人的身体活动量表),疼痛和功能的整体变化(Likert量表)。

在6个月时,共有160名参与者(98%)完成了主要结局的检测。在6个月时痛苦中的变化(平均差,0.0单位[95%CI,-0.9至0.8单位])和功能(平均差,0.3个单位[CI,-3.2至3.7单位])在两组之间没有差异,两组在功能方面都显示出临床相关的改善,干预组在疼痛方面显示出临床相关的改善。次要终点没有组间差异。54%的参与者的疼痛显示出整体改善,功能的整体变化从44%提高到48%。卸载鞋子没有增加改善概率(比值比,疼痛为0.99[CI,0.53至1.86],功能为0.85[CI,0.45至1.61的)。

该研究的限制性为对关节结构的影响没有评价。

卸载膝内侧负担的改良鞋子并没有比传统的步行鞋赋予额外的好处。改良鞋和传统鞋都改善了疼痛和功能。

原始出处:

Rana S. Hinman,Tim V. Wrigley,Ben R. Metcalf,et al.Unloading Shoes for Self-Management of Knee Osteoarthritis,Ann Intern Med,2016.7.11

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    2016-09-07 李东泽

    很好,不错,以后会多学习

    0

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    2016-08-30 ylzr123

    好文,值得学习,赞!

    0

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    2016-07-13 lmm397
  4. [GetPortalCommentsPageByObjectIdResponse(id=113305, encodeId=9194113305d6, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Wed Sep 07 17:31:00 CST 2016, time=2016-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=107361, encodeId=a33910e3613e, content=好文,值得学习,赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Tue Aug 30 11:10:00 CST 2016, time=2016-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1265324, encodeId=7fca12653244c, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Wed Jul 13 23:45:00 CST 2016, time=2016-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1422424, encodeId=66b9142242470, content=<a href='/topic/show?id=96a1858859d' target=_blank style='color:#2F92EE;'>#膝关节骨性关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85885, encryptionId=96a1858859d, topicName=膝关节骨性关节炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=03183693475, createdName=changhe714, createdTime=Wed Jul 13 23:45:00 CST 2016, time=2016-07-13, status=1, ipAttribution=)]

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