组织骨稳态手法对膝骨性关节炎软组织平衡和功能的临床疗效
Clinical Efficacy of Tissue-Bone Homeostasis Manipulation on Soft Tissue Balance and Function in Knee Osteoarthritis.
摘要(中文译文)
膝骨关节炎（KOA）以进行性关节退变及关节周围软组织生物力学失衡为特征，导致疼痛和功能受限。然而，针对调节软组织张力的有效生物力学手法治疗方案仍缺乏足够的标准化。本研究采用随机对照设计，探讨组织-骨骼稳态手法（TBHM）对KOA患者膝关节周围软组织张力及功能结局的影响。共纳入60例患者，随机分配至TBHM组或对照组。主要结局包括股直肌、股内侧肌、股外侧肌肌张力、髌韧带张力及膝关节屈曲活动度（ROM）。次要结局包括膝关节损伤与骨关节炎结局评分（KOOS）及计时起立-行走测试（TUGT）。结果显示，两组基线特征具有可比性（均P > 0.05），干预期间未观察到不良事件。重复测量分析显示，所有主要和次要结局均存在显著的时间效应（P < 0.001）。股直肌、股外侧肌肌张力、髌韧带张力、膝关节屈曲ROM、KOOS各亚量表（症状、日常生活活动、运动/娱乐及生活质量）及TUGT均观察到显著的组×时间交互效应（P < 0.05），表明TBHM组较对照组改善更明显。然而，股内侧肌肌张力及KOOS-疼痛未见显著交互效应（P > 0.05），提示两组在这些指标上趋势相似。综上所述，TBHM在降低KOA患者关节周围软组织张力及改善功能结局方面具有安全性和有效性。该方案为手法治疗干预提供了一种标准化且以生物力学为导向的方法，并可能为优化KOA的保守治疗提供新策略。
Abstract
Knee osteoarthritis (KOA) is characterized by progressive joint degeneration and biomechanical imbalance of periarticular soft tissues, leading to pain and functional limitation. However, effective biomechanically targeted manual therapy protocols for regulating soft tissue tension remain insufficiently standardized. In this study, a randomized controlled design was used to investigate the effects of tissue-bone homeostasis manipulation (TBHM) on peri-knee soft tissue tension and functional outcomes in patients with KOA. Sixty patients were enrolled and randomly assigned to the TBHM group or the control group. Primary outcomes included rectus femoris, vastus medialis, vastus lateralis muscle tension, patellar ligament tension, and knee flexion range of motion (ROM). Secondary outcomes included the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Timed Up and Go Test (TUGT). The results showed that baseline characteristics were comparable between groups (all P > 0.05), and no adverse events were observed during the intervention. Repeated measures analysis revealed significant time effects for all primary and secondary outcomes (P < 0.001). Significant group × time interaction effects were observed for rectus femoris, vastus lateralis muscle tension, patellar ligament tension, knee flexion ROM, KOOS subscales (symptoms, activities of daily living, sport/recreation, and quality of life), and TUGT (P < 0.05), indicating greater improvement in the TBHM group compared with the control group. However, no significant interaction effect was found for vastus medialis muscle tension or KOOS-pain (P > 0.05), suggesting similar trends between groups in these measures. In conclusion, TBHM demonstrates both safety and efficacy in reducing periarticular soft tissue tension and improving functional outcomes in KOA. This protocol provides a standardized and biomechanically oriented approach for manual therapy intervention and may offer a novel strategy for optimizing conservative treatment of KOA.
如何引用
AMA
Lulu Cheng, Sheng Hu, Zhaohui Chen, Dongjing Li, Zeng Chen. Clinical Efficacy of Tissue-Bone Homeostasis Manipulation on Soft Tissue Balance and Function in Knee Osteoarthritis.. Journal of visualized experiments : JoVE. 2026; doi:10.3791/68878.
APA
Lulu Cheng, Sheng Hu, Zhaohui Chen, Dongjing Li, Zeng Chen (2026). Clinical Efficacy of Tissue-Bone Homeostasis Manipulation on Soft Tissue Balance and Function in Knee Osteoarthritis.. Journal of visualized experiments : JoVE. https://doi.org/10.3791/68878
GB/T 7714
Lulu Cheng, Sheng Hu, Zhaohui Chen, Dongjing Li, Zeng Chen. Clinical Efficacy of Tissue-Bone Homeostasis Manipulation on Soft Tissue Balance and Function in Knee Osteoarthritis.[J]. Journal of visualized experiments : JoVE, 2026 doi:10.3791/68878.
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