| Objective:Knee osteoarthritis(KOA)is one of the most common chronic progressive diseases with degenerative destruction of articular cartilage and bone among older adults with KOA.KOA leads to pain,impairs proprioception and reduces functional performance,and deteriorates whole-body dynamic stability.The effect of therapeutic exercise(TE)on the improvement of pain symptoms in KOA patients was small to moderate and had a short-term effect.Traditional Chinese herb hot compress(TCHHC)has the dual effects of drug therapy and hyperthermia,and may have the potential to enhance the TE.Therefore,this study compared and analyzed the effects of 8-week TCHHC+TE and TE on pain,proprioception,functional mobility and dynamic stability during stepping over obstacles among older adults with KOA,which can provide scientific basis and theoretical support for the clinical treatment and promote the comprehensive recovery among older adults with KOA.Methods:Thirty-four participants who met the above criteria were assigned to the TCHHC+TE or the TE groups at a ratio of 1:1.The participants in the TCHHC+TE group received TCHHC+TE,and those in the TE group received TE for 90 min,3times a week for 8 weeks.Final analyses were conducted among thirteen participants in the TCHHC+TE group and fourteen in the TE group.At week 0 and week 9,the Western Ontario and Mc Master Universities Osteoarthritis Index(WOMAC)was used to assess the pain score of the more affected leg,the proprioceptive testing system was used to measured joint proprioception in the lower extremities,and Timed up&Go(TUG)and 20-m walk tests have been used effectively to quantify functional performance among older adults with KOA.A motion system(Vicon,Oxford Metrics Ltd.,UK)and two force platforms(AMTI,BP600900,USA)were used to collect the margin of stability(MOS)of the more affected leg during stepping over obstacle.Two-way ANOVA with repeated measures was adopted to analyze the data.Results:1.Interaction effect:After 8 weeks of intervention,significant interactions were detected in pain scores(p=0.047,η_p~2=0.148),proprioception thresholds of knee extension(p=0.018,η_p~2=0.203)and ankle plantarflexion(p=0.010,η_p~2=0.235),TUG(p=0.046,η_p~2=0.150)and 20-m walk(p=0.008,η_p~2=0.249)tests and the MOS(p<0.001,η_p~2=0.425)in the anteroposterior(AP)direction.Compared with week 0,the pain score of both groups(TCHHC+TE:p<0.001,d=2.246;TE:p<0.001,d=1.760),the proprioception thresholds of the knee extension and ankle plantarflexion of both groups(TCHHC+TE:p<0.001,d=1.870,p<0.001,d=2.434;TE:p=0.007,d=0.927,p<0.001,d=1.352),the times of the TUG and 20-m walk tests of both groups(TCHHC+TE:p<0.001,d=4.420,p<0.001,d=3.400;TE:p<0.001, d=3.113,p<0.001,d=2.543)and the MOS(p<0.001,d=2.646)in the AP direction of the TCHHC+TE group decreased at week 9.The pain score(p=0.035,d=0.798),proprioception threshold of knee extension(p=0.022,d=0.967),the times of the TUG(p=0.022,d=0.957)and 20-m walk tests(p=0.044,d=0.820)and MOS(p<0.001,d=1.265)was lower in the TCHHC+TE group compared with those in the TE group at week 9.2.Intervention main effect:After 8 weeks of intervention,both groups had significant time effects were detected in proprioception thresholds of knee flexion(p<0.001,η_p~2=0.596),ankle dorsiflexion(p<0.001,η_p~2=0.446),ankle inversion(p<0.001,η_p~2=0.148)and eversion(p<0.001,η_p~2=0.246)and the COP(p=0.007,η_p~2=0.255)in the AP direction.Conclusion:(1)Both the 8-week TCHHC+TE and TE can relieve pain,recover proprioception,and improve functional mobility among older adults with KOA.(2)TCHHC+TE also has the effect of improving the dynamic stability,and compared with TE,the 8-week TCHHC+TE was superior in relieving pain,recovering proprioception,improving functional performance,and dynamic stability during stepping over obstacles among older adults with KOA.It is recommended that TCHHC should be adopted prior to TE to enhance the effects of KOA rehabilitation. |
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