等速限弧运动对膝关节炎功能影响
Impact of qualified arc angle isokinetic training on the function of knee osteoarthritis
目的 探讨股四头肌限弧等速运动角度对膝骨性关节炎患者的疗效。 方法 共78例右膝骨性关节炎患者纳入研究，按随机法赋值从大到小分成3组，每组26例。3组除常规运动训练外，进行不同角度的限弧等速运动训练。训练弧度分别为：A组膝屈90°→10°，B组膝屈60°→10°，C组膝屈30°→10°。每周3 次, 训练 8 周。在治疗前后分别采用疼痛视觉模拟评分法（VAS）评估疼痛改善程度，采用美国特种外科医院（HSS）指数评定膝关节功能情况，同时等速训练仪测定患膝峰力矩（peak torque，PT）、本体感觉误差均值。 结果 3组疼痛、HSS指数、PT较治疗前差异有显著性意义（P <0.05），A组优于B组、C组（P <0.05）；治疗后各组本体感觉较治疗前略有改善，但3组改善程度无统计学差异（P> 0.05）。 结论 不同弧度等速运动可以改善膝关节功能，较大弧度的限弧等速运动获益更明显。
Objective To evaluate the effect of qualified arc angle isokinetic training on the function of Knee osteoarthritis. Methods 78 participants with right knee osteoarthritis were divided randomly into group A, group B, and group C. There were 26 cases in each group. Aside from regular exercise therapy, patients in all groups also accepted isokinetic training. Patients in group A accepted isokinetic exercise knee of extension training with 90 ° to 10 °; Patients in group B accepted knee extension isokinetic exercise training with 60 ° to 10 °; patients in group C accepted knee extension isokinetic exercise training with 30 ° to 10 °. All groups were trained 3 times per week, and the training lasted for 8 weeks in total. American hospital for special surgery index（HSS）, maximum peak torque (PT), visual analogue scale method (VAS), and joint motion detection threshold (JMDT) were assessed before and after the treatments in 3 groups. Results There was significant difference in the PT, HSS, and VAS compared to the prior treatment (P<0.05), Group A improved significantly than Group B and Group C. JMDT turned better than before but there was no significant difference (P>0.05). Conclusion Different qualified arc angle isokinetic training can make an improvement on knee function. Larger arc angle isokinetic training can help knee function evidently.
[1] Hortobagyi T, Garry J, Holbert D, et al. Aberrations in the control of quadriceps muscle force in patients with knee osteoarthritis[J]. Arthritis Rheum, 2004, 51(4):562-569.
[2] Jadelis K, Miller ME, Ettinger WH Jr, et al. Strength, balance, and the modifying effects of obesity and knee pain: results from the observational arthritis study in seniors (oasis) [J]. JAm Geriatr Soc, 2001, 49(7): 884-891.
[3] Slemenda C, Brandt KD, Heilman DK, et al. Quadriceps weakness and osteoarthritis of the knee [J]. Ann Intern Med, 1997, 127(2): 97-104.
[4] Hurley MV, Scott DL, Rees J, et al. Sensorimotor changes and functional performance in patients with knee osteoarthritis [J]. Ann Rheum Dis, 1997, 56(11):641-648.
[5] van Baar ME, Dekker J, Oostendorp RA, et al. The effectiveness of exercise therapy in patients with osteoarthritis of the hip or knee: a randomized clinical trial [J]. J Rheumatol,1998,25(12):2432-2439.
[6] 杨俊兴, 袁颖嘉, 李田珂, 等. 等速向心肌力训练对膝关节骨性关节炎患者关节功能水平的影响[J]. 中国康复医学杂志. 2012, 27 (7) :631-634.
[7] Altman R, Asch E, Bloch D, et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association[J]. Arthritis Rheum, 1986,29(8):1039-1049.
[8] 卓大宏. 中国康复医学[M]. 北京: 华夏出版社, 2003: 1205.
[9] Baker K, McAlindon T. Exercise for knee osteoarthritis[J]. Curr Opin Rheumatol, 2000, 12(5):456-463.
[10] van Baar ME, Dekker J, Oostendorp RA, et al. The effectiveness of exercise therapy in patients with osteoarthritis of the hip or knee: a randomized clinical trial [J]. J Rheumatol, 1998, 25(12): 2432-2439.
[11]Knoop J, Steultjens MP, van der Leeden M, et al. Proprioception in knee osteoarthritis:a narrative review[J]. Osteoarthritis Cartilage, 2011,19(4):381-388.
[12] Slemenda C, Heilman DK, Brandt KD, et al. Reduced quadri-ceps strength relative to body weight: a risk factor for knee osteoarthritis in women[J]? Arthritis Rheum, 1998, 41(11): 1951-1959.
[13] Herzog W, Longino D, Clark A. The role of muscles in joint adaptation and degeneration[J]. Langenbecks Arch Surg, 2003, 388(5):305-315.
[14]Thomas AC. Sowers M, Karvonen-Gutierrez C, et al. Lack of quadriceps dysfunction in women with early knee osteoarthritis[J]. J Orthop Res, 2010, 28(5): 595-599.
[15]梁成军. 肌肉力量训练神经适应机制研究综述[J]. 吉林体育学院学报, 2013, 29 (3): 14-17.
[16]杜毅, 王俊华, 舒思明, 等. 膝骨性关节炎患者股四头肌峰力矩与疼痛程度相关性研究[J]. 亚太传统医药, 2014, 10(5): 18-20.
京ICP备08002354号-3/
| 〈 |
|
〉 |
