目的 探讨术前高强度间歇训练对膝关节骨性关节炎（KOA）患者行全膝关节置换术（TKA）后康复效果的影响。方法 选取2020-01至2024-06在武警特色医学中心运动医学科拟行单侧TKA的KOA患者50例,随机分为观察组和对照组,每组25例。观察组术前接受高强度间歇训练,对照组接受中低等强度训练,时间均为6周;记录两组患者干预前（T0）、术前（T1）、术后1个月（T2）及术后3个月（T3）大摄氧量（VO2max）、膝关节功能评分（HSS）、疼痛评分（VAS）、被动膝关节活动度（PROM）、30 s起立测试（STS）及靠墙静蹲测试（IST）,并进行对比分析。对比两组患者训练期间不良反应发生率。结果 T0时,两组患者各项观察指标差异无统计学意义。观察组T1~T3各时间点的VO2max均显著高于对照组,差异有统计学意义（P<0.05）;T3时间点,观察组的HSS评分为（87.84±3.01）、PROM为114.00、VAS评分为1.50,与对照组比较,差异均有统计学意义（P<0.05）;STS和IST结果分别为（22.54±3.14）次和（70.60±14.27）s,均显著优于对照组,差异有统计学意义（P<0.05）。广义估计方程分析显示,年龄对VO2max存在显著负面影响（P<0.05）,BMI对PROM和IST亦具有显著不良影响（P<0.05）。高强度间歇训练干预期间未见严重不良事件,干预整体安全可控。结论 术前高强度间歇训练能改善KOA患者的心肺功能、膝关节功能和下肢肌耐力,减轻术后疼痛,是一种安全可行的术前运动干预手段。
Abstract
Objective To evaluate the effects of preoperative high-intensity interval training （HIIT） on the rehabilitation effect of total knee arthroplasty（TKA）in patients with knee osteoarthritis （KOA）. Methods A total of 50 KOA patients scheduled for unilateral TKA at the Characteristics Medical Center of Chinese People’s Armed Police Force between January 2020 and June 2024 were enrolled and randomly assigned into an observation group or a control group, with 25 patients in each group. The observation group underwent a 6-week preoperative high-intensity interval training （HIIT）, while the control group received moderate-intensity training for 6 weeks. Assessments were conducted at baseline （T0）, preoperatively （T1）, and at 1 month （T2） and 3 months （T3） postoperatively, including maximal oxygen uptake （VO2max）, Hospital for Special Surgery （HSS） knee score, visual analog scale （VAS） for pain, passive range of motion （PROM）, 30-second sit-to-stand test （STS）, and wall-sit time （IST）. The incidence of adverse events during the intervention period was also compared between the two groups. Results Baseline features and outcome measures showed no significant differences between groups at T0. Compared with the control group,the observation group demonstrated significantly higher VO2max at all post-intervention time points （T1-T3） （P<0.05）. At T3, the observation group achieved superior outcomes in HSS score （87.84 ± 3.01）, PROM （114.00）, and VAS score 1.50 （P<0.05）, as well as in STS （22.54 ± 3.14） repetitions and IST （70.60 ± 14.27） s （P<0.05）. Generalized estimating equation analysis revealed that age was negatively correlated with VO₂max （P<0.05）, and BMI had a significant adverse effect on PROM and IST （P<0.05）. No severe adverse events were reported, confirming the safety and feasibility of the HIIT protocol. Conclusions Preoperative HIIT is a safe and feasible preoperative exercise intervention method, which can improve the cardiopulmonary fitness,knee joint function,and lower limb muscular endurance in KOA patients,and alleviate postoperative pain.
关键词
膝关节骨性关节炎 /
全膝关节置换术 /
高强度间歇训练 /
心肺功能 /
康复效果
Key words
knee osteoarthritis /
total knee arthroplasty /
high-intensity interval training /
cardiopulmonary function /
rehabilitation outcomes
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