Mr Adrian Ram, Matthew D Jones, A/Prof Jeanette Thom, Dr John Booth, Dr Mitchell T. Gibbs, Mr Anurag Pandit, Mr Alexandre Kovats, Mr Pramod Ram
{"title":"膝关节骨性关节炎患者的疼痛运动与非疼痛运动:一项可行性研究","authors":"Mr Adrian Ram, Matthew D Jones, A/Prof Jeanette Thom, Dr John Booth, Dr Mitchell T. Gibbs, Mr Anurag Pandit, Mr Alexandre Kovats, Mr Pramod Ram","doi":"10.31189/2165-7629-13-s2.471","DOIUrl":null,"url":null,"abstract":"\n \n Painful exercise reduces pain in the short-term compared to non-painful exercise in people with chronic pain. However, integration of painful exercise into knee osteoarthritis (OA) treatment is contentious among clinicians, with the clinical implications unknown. This study aimed to explore the feasibility of painful versus non-painful exercise in people with knee OA.\n \n \n \n Participants were randomised into a painful (INT; RPE 5-6) or non-painful (CON; RPE 4-5) who performed exercise twice per week for 6 weeks. Both groups also received standardised education. The primary outcomes were feasibility, assessed using participant recruitment, retention, adherence, and compliance rates. Secondary outcomes included pain, function, strength, pressure pain thresholds, psychosocial measures and adverse events. Immediate pre- and post-exercise pain were also measured.\n \n \n \n 21 people with knee OA (66 ± 9 years old; BMI: 29.4 ± 8.1) completed the study. Feasibility was achieved and supported by high rates of recruitment (INT = 89%, CON 89%), retention (INT = 91%, CON = 100%), adherence (INT = 91%, CON = 92%), and compliance (INT = 72%, CON = 81%). Pain reduced in both groups (mean difference [95% CI]; INT = -0.7 [-1.8 to 0.4]; CON = -1.5 [-2.7 to 0.4]), and strength (1-RM leg press) improved with a moderate effect in favour of INT (12.8 [0.2 to 25.9], d = 0.97, p = 0.046).\n \n \n \n Incorporating painful exercise into treatment for individuals with knee OA is feasible. Several potential benefits include positive changes in maladaptive beliefs and behaviours and enhanced systemic benefits associated with higher intensity exercise. Future research comparing the efficacy of painful versus non-painful exercise in knee OA and other chronic musculoskeletal conditions is warranted.\n","PeriodicalId":92070,"journal":{"name":"Journal of clinical exercise physiology","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"PAINFUL VS NON-PAINFUL EXERCISE IN PEOPLE WITH KNEE OSTEOARTHRITIS: A FEASIBILITY STUDY\",\"authors\":\"Mr Adrian Ram, Matthew D Jones, A/Prof Jeanette Thom, Dr John Booth, Dr Mitchell T. Gibbs, Mr Anurag Pandit, Mr Alexandre Kovats, Mr Pramod Ram\",\"doi\":\"10.31189/2165-7629-13-s2.471\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"\\n \\n Painful exercise reduces pain in the short-term compared to non-painful exercise in people with chronic pain. However, integration of painful exercise into knee osteoarthritis (OA) treatment is contentious among clinicians, with the clinical implications unknown. This study aimed to explore the feasibility of painful versus non-painful exercise in people with knee OA.\\n \\n \\n \\n Participants were randomised into a painful (INT; RPE 5-6) or non-painful (CON; RPE 4-5) who performed exercise twice per week for 6 weeks. Both groups also received standardised education. The primary outcomes were feasibility, assessed using participant recruitment, retention, adherence, and compliance rates. Secondary outcomes included pain, function, strength, pressure pain thresholds, psychosocial measures and adverse events. Immediate pre- and post-exercise pain were also measured.\\n \\n \\n \\n 21 people with knee OA (66 ± 9 years old; BMI: 29.4 ± 8.1) completed the study. Feasibility was achieved and supported by high rates of recruitment (INT = 89%, CON 89%), retention (INT = 91%, CON = 100%), adherence (INT = 91%, CON = 92%), and compliance (INT = 72%, CON = 81%). Pain reduced in both groups (mean difference [95% CI]; INT = -0.7 [-1.8 to 0.4]; CON = -1.5 [-2.7 to 0.4]), and strength (1-RM leg press) improved with a moderate effect in favour of INT (12.8 [0.2 to 25.9], d = 0.97, p = 0.046).\\n \\n \\n \\n Incorporating painful exercise into treatment for individuals with knee OA is feasible. Several potential benefits include positive changes in maladaptive beliefs and behaviours and enhanced systemic benefits associated with higher intensity exercise. Future research comparing the efficacy of painful versus non-painful exercise in knee OA and other chronic musculoskeletal conditions is warranted.\\n\",\"PeriodicalId\":92070,\"journal\":{\"name\":\"Journal of clinical exercise physiology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of clinical exercise physiology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.31189/2165-7629-13-s2.471\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of clinical exercise physiology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.31189/2165-7629-13-s2.471","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
与非疼痛性运动相比,疼痛性运动能在短期内减轻慢性疼痛患者的疼痛。然而,在膝关节骨性关节炎(OA)治疗中纳入疼痛运动在临床医生中存在争议,其临床影响尚不清楚。本研究旨在探讨膝关节OA患者进行有痛运动与无痛运动的可行性。 参与者被随机分为疼痛组(INT;RPE 5-6)和非疼痛组(CON;RPE 4-5),每周进行两次锻炼,为期 6 周。两组参与者都接受了标准化教育。主要结果是可行性,通过参与者招募率、保留率、坚持率和达标率进行评估。次要结果包括疼痛、功能、力量、压痛阈值、社会心理测量和不良事件。此外,还对运动前后的即时疼痛进行了测量。 21 名膝关节 OA 患者(66 ± 9 岁;BMI:29.4 ± 8.1)完成了研究。招募率(INT=89%,CON=89%)、保留率(INT=91%,CON=100%)、坚持率(INT=91%,CON=92%)和依从性(INT=72%,CON=81%)都很高。两组患者的疼痛均有所减轻(平均差异[95% CI];INT = -0.7 [-1.8 to 0.4];CON = -1.5 [-2.7 to 0.4]),力量(1-RM 压腿)有所改善,INT 的效果适中(12.8 [0.2 to 25.9],d = 0.97,p = 0.046)。 将疼痛锻炼纳入膝关节 OA 患者的治疗是可行的。其潜在益处包括:积极改变不适应的信念和行为,以及与高强度运动相关的系统性益处。未来有必要对膝关节OA和其他慢性肌肉骨骼疾病患者进行研究,比较疼痛运动和非疼痛运动的疗效。
PAINFUL VS NON-PAINFUL EXERCISE IN PEOPLE WITH KNEE OSTEOARTHRITIS: A FEASIBILITY STUDY
Painful exercise reduces pain in the short-term compared to non-painful exercise in people with chronic pain. However, integration of painful exercise into knee osteoarthritis (OA) treatment is contentious among clinicians, with the clinical implications unknown. This study aimed to explore the feasibility of painful versus non-painful exercise in people with knee OA.
Participants were randomised into a painful (INT; RPE 5-6) or non-painful (CON; RPE 4-5) who performed exercise twice per week for 6 weeks. Both groups also received standardised education. The primary outcomes were feasibility, assessed using participant recruitment, retention, adherence, and compliance rates. Secondary outcomes included pain, function, strength, pressure pain thresholds, psychosocial measures and adverse events. Immediate pre- and post-exercise pain were also measured.
21 people with knee OA (66 ± 9 years old; BMI: 29.4 ± 8.1) completed the study. Feasibility was achieved and supported by high rates of recruitment (INT = 89%, CON 89%), retention (INT = 91%, CON = 100%), adherence (INT = 91%, CON = 92%), and compliance (INT = 72%, CON = 81%). Pain reduced in both groups (mean difference [95% CI]; INT = -0.7 [-1.8 to 0.4]; CON = -1.5 [-2.7 to 0.4]), and strength (1-RM leg press) improved with a moderate effect in favour of INT (12.8 [0.2 to 25.9], d = 0.97, p = 0.046).
Incorporating painful exercise into treatment for individuals with knee OA is feasible. Several potential benefits include positive changes in maladaptive beliefs and behaviours and enhanced systemic benefits associated with higher intensity exercise. Future research comparing the efficacy of painful versus non-painful exercise in knee OA and other chronic musculoskeletal conditions is warranted.