骨關節炎患者之健康管理：漸增阻力運動與神經肌肉運動之療效

Health Management for Patients with Osteoarthritis (OA):the Effect of Incremental Resistance Exercise (IRE) and Neuromuscular Exercise (NME)

"本研究探討漸增阻力運動與神經肌肉運動對骨關節炎（osteoarthritis, OA；或稱：退化性關節炎）患者之療效。採實驗計劃法，11位（3男8女）退化性膝關節炎患者參與本次實驗，平均年齡59.5（標準差9.6）歲，透過隨機控制試驗將參與者分配至「漸增阻力運動」與「神經肌肉運動」兩組之一。膝關節炎患者在運動「訓練後」於WOMAC（Western Ontario and McMaster Universities Osteoarthritis Index）與SF-36（Short Form-36）量表方面，各項指標都比「訓練前」有較佳的表現，其中「WOMAC總分、WOMAC-疼痛、WOMAC-身體功能、SF36總分」這四項指標在「訓練前／後」之差異達顯著水準；因此對於膝關節炎患者而言，應將運動納為治療的一部分。此外「神經肌肉運動」組在「SF36總分、SF36-身體總評」兩指標，顯著優於傳統的「漸增阻力運動」組；但在其他指標的差異並未達顯著水準。整體而言，本研究所發展的「神經肌肉運動」處方初步成效不錯，但仍有改進空間。另一方面，傳統「漸增阻力運動」可改善肌肉強度、自覺疼痛衡量及身體機能，因此在更有效能的結構化「神經肌肉運動」課程還未發展完善前，不宜偏廢。"

This study investigated the effects of incremental resistance exercise (IRE) and neuromuscular exercise (NME) on patients with osteoarthritis (OA). Using the experimental design, 11 patients (3 males and 8 females) with knee OA (M = 59.5 yr., SD = 9.6 yr.) took part in the experiment. The participants were assigned to the group of IRE or NME through randomized controlled trials (RCTs). After 12 weeks of exercise training, all knee OA patients showed better performance on the WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) and SF-36 (Short Form-36) index than before. Four indicators including WOMAC-total, WOMAC-pain, WOMAC-physical function, and SF36-total showed significant improvement; therefore, it is recommended that exercise should be included as part of the treatment for patients with knee OA. In addition, the NME group did significantly better on SF36-total and SF36-PCS (Physical Component Summary) indicators than that of the traditional IRE group; however, the differences in other indicators were not significant. The NME prescription developed in this study showed promising initial results, but there is still room for improvement. On the other hand, traditional IRE also improves muscle strength, self-reported pain measures and physical function. Therefore, it should not be overlooked until a more effective and structured NME recipe is developed.