| Knee osteoarthritis(KOA) is a chronic degenerative disease, characterized by degeneration of knee cartilage and secondary hyperostosis. Knee OA is accompanied by pain, stiffness, poor proprioception, periarticular muscle atrophy, restricted movement, and decreased physical activity. KOA one of the most common joint disorders in the elderly which could be associated with considerable physical disability. KOA is one of the top five causes of disability, with 80% of patients with the condition experiencing some degree of movement limitation affecting activities of daily living. There are many treatment methods of controlling the symptoms of acute KOA, most of them are effective. However, most treatment programs ignore the concept of prevention and treatment.We reviewed relevant literatures, to be made a more effective rehabilitation program for patients with acute KOA.Purpose : The purpose of our study was to investigate the effects of isokinetic strength training combined with low-level laser therapy for patients with acute KOA.Methods:The study was carried out at the Physical Therapy and Rehabilitation Department of Tianjin People’s Hospital. One hundred and five patients who had KOA according to inclusion criteria were recruited for the study. All participants were randomly assigned into four groups: treatment group 1; treatment group 2; treatment group 3 and control group. The control group received pharmacologic treatment. The treatment group 1 received pharmacologic treatment and low-level laser therapy. The treatment group 1 received pharmacologic treatment and isokinetic strength training. The treatment group 1 received pharmacologic treatment,low-level laser therapy and isokinetic strength training. At the time of before treatment and after treated for 4 weeks, knee pain, knee mobility,quality of life,(using the WOMAC Osteoarthritis Index-Physical Function subscale), muscle strength(isokinetic dynamometer),balance(with the help of a force platform) and the function of quadriceps and hamstrings(with surface electromyography).Results: 1.WOMAC between groupsAfter 4 weeks of treatment, the scores of knee pain,stiffness and function showed significant lower(P<0.01)with patients in all groups. Compared with the control group,all of the score in the group 3 showed significant lower(P<0.01);The scores of knee pain and stiffness showed lower(P<0.05) with patients in group 1. Compared with the group 2,the total score showed lower(P<0.05)with patients in group 1.We can conclude that drug treatment combination laser therapy and isokinetic strength training is the best method of treatment for patients with acute KOA.2.Balance between groups2.1 Bipedal standing with eyes open.After 4 weeks of treatment,the EA and L of the COP showed lower with patients in control group;the EA and L of the COP showed significant lower(P<0.01)with patients in treatment groups. Compared within the groups, the EA of the COP showed the lowest with patients in group3.We can conclude that drug treatment combination laser therapy and isokinetic strength training is the best method of treatment for patients with acute KOA.2.2 Bipedal standing with eyes closed.After 4 weeks of treatment,the EA and L of the COP showed lower with patients in all groups. Compared with the control group, the EA and L of the COP showed significant lower(P<0.01) with patients in group3.We can conclude that drug treatment combination laser therapy and isokinetic strength training is the best method of treatment for patients with acute KOA.3. Proprioception between groupsAfter 4 weeks of treatment,there were no significant differences in the proprioception parameters in the control group. The ATE 、 SI showed lower( P<0.05) in the group1. The ATE、SI showed significant lower(P<0.01)with patients in group2 and group3. Compared with the control group, the ATE、SI showed significant lower(P<0.01)with patients in group3.We can conclude that drug treatment combination laser therapy and isokinetic strength training is the best method of treatment for patients with acute KOA.4.EMG activity between groups during bipedal standce with eyes closed.After 4 weeks of treatment, there were no significant differences in the EMG activity parameters in the control group. The activation of the vastus medialis showed higher(P<0.05)in the group1. The activation of the vastus medialis, vastus lateralis, rectus femoris showed higher in the group2. The activation of the vastus medialis, vastus lateralis, rectus femoris showed significant higher( P<0.01) in the group3. Compared with the control group, the activation of the vastus medialis showed significant higher(P<0.01) in the group3, the activation of the vastus lateralis showed higher in the group2 and group3, the activation of the rectus femoris showed higher in the group3, the activation of the biceps femoris showed significant higher(P<0.01) in the group3.We can conclude that drug treatment combination laser therapy and isokinetic strength training is the best method of treatment for patients with acute KOA.5. Muscle strength between groupsAfter 4 weeks of treatment, the PT、PW showed higher(P<0.05) in the control group and group1,the PT、PW、AW、AP showed significant higher(P<0.01) in the group2 and group3. Compared within the groups, the group3 was more effective than the other groups, the group1 and group2 was more effective than the control group. We can conclude that drug treatment combination laser therapy and isokinetic strength training is the best method of treatment for patients with acute KOA.Conclusion: Based on the above results, we can draw the following conclusion: Oral medications combination laser therapy and isokinetic strength training has a significant effect on reliving the pain, stiffness and dysfunction, improving proprioception, muscle strength and muscle activation in patients with KOA. |
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