The Effect Of Different Exercise Modes On Serum Immune Indexes In Patients With Knee Osteoarthritis

Objectives:By observing the effects of different exercise modes on the serum immune indexes in the elderly patients with knee osteoarthritis,explore the mechanisms of different exercise interventions on knee osteoarthritis,and then provide scientific basis for prevention and improvement of knee osteoarthritis.Methods:The study is a randomized controlled trial.the 120 eligible patients suffered from knee osteoarthritis,came from the community of Fujian city in Fuzhou Province,were randomly divided into Tai Chi group,Baduanjin group,cycle-ergometer group and health education group.Tai Chi group received Tai Chi exercise and health education,Baduanjin group received Baduanjin Exercise and health education,cycle-ergometer group received cycle-ergometer exercise and health education group conducted health lectures.12 weeks(1 time a day,60 minutes each time,5 times a week)were last in the intervention period of each groups.All outcome indicators were tested at baseline,after the intervention period(12 weeks).Primary outcomes included Western Ontario and McMaster University Osteoarthritis Index(WOMAC),Six-Mimute Walk Test(6MWT),and serum T Cell Immunoglobulin Mucin 3(Tim-3),Programmed Death 1(PD-1),Interferon Gamma(IFN-?),Brain Derived Neurotrophic Factor(BDNF),which detected by ELISA.Results:1.Scores of WOMAC scale in each group after intervention.Compared with pre-intervention,the scores of pain and physical function significantly decreased in Tai Chi group,Baduanjin group and cycle-ergometer group after intervention(P<0.01),while there was no significant difference in health education group(P>0.05).Tai Chi group stiffness score significantly decreased between pre-intervention and post-intervention(P<0.01),while there was no significant difference in Baduanjin group,cycle-ergometer group,and health education group(P>0.05).Furthermore,the improvement of pain in Tai Chi group and cycle-ergometer group were significantly better than health education group(P<0.01),in Baduanjin group was better than health education group(P<0.05).the improvement of stiffness in Tai Chi group was better than cycle-ergometer group(P<0.05)and significantly better than health education group(P<0.01).the improvement of physical function in Tai Chi group,Baduanjin group and cycle-ergometer group were significantly better than health education group(P<0.01).2.After the twelve-week intervention,the Tai Chi group and the Baduanjin group,cycle-ergometer group Six-Mimute Walk Test(6MWT)distances were no significant differences,compared with pre-intervention(P>0.05),and the health education group decreased after intervention(P<0.05).the function of 6MWT distances in Tai Chi group,Baduanjin group,cycle-ergometer group better than health education group.3.Detection of serum markers in each group after intervention.Compared with pre-intervention,the levels of Tim-3 levels significantly increased in Tai Chi group,Baduanjin group,and cycle-ergometer group(P<0.01),and increased in health education group after intervention(P<0.05).The levels of PD-1 increased in Tai Chi group(P<0.05),and significantly increased in cycle-ergometer group after intervention(P<0.01),while there were no significant differences in Baduanjin group and health education group(P>0.05).The levels of IFN-? in Tai Chi group,Baduanjin group and cycle-ergometer group were significantly decreased(P<0.01),while there was no significant difference in health education group(P>0.05).There was no significant differences in the level of BDNF in each group after intervention(P>0.05).Furthermore,The level of Tim-3 level in Tai Chi group,Baduanjin group and cycle-ergomete were significantly higher than health education group(P<0.01),the level of PD-1 in cycle-ergometer group was significantly higher than health education group(P<0.01).The level of IFN-y in Tai Chi group and cycle-ergometer group were significantly lower than health education group(P<0.01),and in Baduanjin group was lower than health education group(P<0.05).There were no significant differences in the levels of BDNF between the groups(P>0.05).4.The level of Tim-3 was negative correlation with stiffness and physical function scores of WOMAC scale,Tim-3 level was positive correlation with Six-Mimute Walk Test(6MWT)distances,but there was no significant difference between the other indexes(P>0.05).Conclusion:1.Tai Chi,Baduanjin and cycle-ergometer training can improve the symptoms of pain and physical function and walking capacity in community elderly patients with knee osteoarthritis.Furthermore,Tai Chi can be targeted to improve the symptoms of stiffness.2.Tai Chi,Baduanjin and cycle-ergometer may improve the symptoms of patients with knee osteoarthritis by increasing the serum levels of Tim-3 and PD-1,and then decreasing the level of IFN-Y.Moreover,Tim-3 is the main factor of autoimmunity,but PD-1 is only a cofactor in Tim-3 expression.