| Objective:Knee osteoarthritis(KOA)is a chronic disease caused by knee joint degeneration,inflammation,heredity and other factors.The prevalence of KOA among the elderly aged 65 and over in China is about 17%,and there are currently about 50 million to 70 million KOA patients.The main clinical manifestations of KOA include knee pain,stiffness,decreased range of motion,lower limb muscle strength reduction and abnormal gait.At present,the clinical treatment of KOA is diverse,but the lack of scientific,standardized,and effective therapies is an urgent problem to be solved.Exercise therapy can improve muscle strength and joint angle,which has been widely used in clinical practice,but it has not improved the pain and swelling symptoms of KOA patients,and patients have poor compliance with prescription execution due to pain during exercise therapy interventions;The external application of “Hanshibitong formula” can be directly applied to the affected part of the knee joint to form a local absorption of drug,which has the effect of alleviating the pain and swelling of the knee joint of KOA patients.The combined application of the two may be more beneficial to rehabilitation.This study conducted intervention on elderly KOA patients through external application of traditional Chinese medicine combined with exercise therapy to explore the clinical efficacy of this therapy in interfering with KOA.Based on motion capture and three-dimensional dynamometry,changes in the biomechanical characteristics of KOA patients were detected,with a view to optimizing the clinical treatment plan for KOA and provide reference for quantitative efficacy evaluation indicators.Method:In this study,we selected KOA patients who were treated in the neck,shoulder,waist and leg pain Hospital Affiliated to Shandong First Medical University from June2021 to February 2022,and included 34 patients who were≥65 years old and met the KOA diagnostic criteria in the American Society of Rheumatology and the Guidelines for the Diagnosis and Treatment of Common Diseases in the Department of Orthopedics and Traumatology of Traditional Chinese Medicine into the experiment,and were randomly divided into the experimental group and the control group.The experimental group received “Hanshibitong formula” combined with exercise therapy intervention,while the control group received exercise therapy intervention,three times a week for 8weeks.After 8 weeks of intervention,there were 13 people in the experimental group and 14 in the control group.Before and after the intervention,all patients were required to undergo four tests,including VAS pain score,five sitting and standing tests,isokinetic muscle strength test and gait detection when walking up stairs.The gait detection used the Vicon infrared motion capture system with 12 cameras and the three-dimensional dynamometer to collect the dynamics and kinematics data of KOA patients when walking up stairs.In this study,two-dimensional repetitive analysis of variance was used for statistical analysis of various indicators.Results:1.Pain score resultsAfter 8 weeks of intervention,significant interaction was detected in the pain score(P<0.001).The results of post-test showed that the pain scores of the experimental group and the control group decreased significantly after the intervention compared with those before the intervention(P=0.007;P=0.005).After the intervention,the pain score of the experimental group was lower than that of the control group(P<0.001).2.Five sitting and standing time resultsSignificant interaction was detected after sitting for 5 weeks(P=0.042).The results of five sitting and standing time showed that after the intervention,the number of sitting and standing for five times in the experimental group and the control group decreased significantly compared with that before the intervention(P<0.001;P<0.001).After the intervention,the five times of sitting and standing in the experimental group were less than those in the control group(P=0.014).3.Lower limb muscle strength resultsAfter 8 weeks of intervention,no significant interaction was detected in the peak buckling moment and the peak flexion moment to body weight ratio(P=0.055;P=0.087).After 8 weeks of intervention,significant interaction was detected in the peak moment of extension and the stretching peak moment to weight ratio(P=0.003;P=0.002).The results of post-mortem test showed that the peak stretching moment and the stretching peak moment to weight ratio of the experimental group and the control group increased significantly after the intervention compared with that before the intervention(P=0.026,P=0.014;P<0.001;P=0.006).After the intervention,the peak moment of extension and the stretching peak moment to weight ratio in the experimental group were greater than that in the control group(P=0.040;P=0.032).4.Results of biomechanical parameters of walking up stairsAfter 8 weeks of intervention,significant interaction was detected in the maximum knee flexion angle in the stair walking gait test(P<0.001).The results of post-test showed that the maximum knee flexion angle of the experimental group and the control group increased significantly after the intervention compared with that before the intervention(P<0.001;P<0.001).After the intervention,the maximum knee flexion angle in the experimental group was greater than that in the control group(P<0.001).After 8 weeks of intervention,significant interaction was detected in the peak knee adduction torque in the stair climbing gait test(P<0.001).The results of post-test showed that the peak torque of knee adduction in the experimental group and the control group decreased significantly after the intervention compared with that before the intervention(P=0.002;P=0.019).After the intervention,the peak torque of knee adduction in the experimental group was lower than that in the control group(P<0.001).After 8 weeks of intervention,significant interaction was detected in dynamic stability in stair walking test(P=0.003;P<0.001).The results of post-test showed that after the intervention,the dynamic stability of ascending stairs in the experimental group and the control group decreased significantly compared with that before the intervention(P < 0.001,P < 0.001;P < 0.001,P=0.005).After the intervention,the dynamic stability of the experimental group was lower than that of the control group(P=0.044;P=0.041).Conclusion:1.External application of traditional Chinese medicine combined with exercise therapy group and exercise therapy group both reduced the pain of the elderly KOA patients,improved the ability of sitting and standing conversion,increased the muscle strength of knee extension and improve the gait strategy of walking upstairs;2.The combination of traditional Chinese medicine external application and exercise therapy is superior to simple exercise therapy in the above four aspects. |
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