| 李宽,王春方,孙长城,张颖.限弧等速肌力训练对于髌股关节炎髌骨轨迹的影响[J].中国康复,2020,35(8):413-417 |
| 限弧等速肌力训练对于髌股关节炎髌骨轨迹的影响 |
| Effect of arc limitation isokinetic muscle strength training on the mal-patellar tracking of patients with patellofemoral arthritis |
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| DOI： |
| 中文关键词: 等速肌力训练 髌股关节炎 髌骨轨迹 股内斜肌 |
| 英文关键词: isokinetic training mal-patellar tracking patellofemoral osteoarthritis vastus medialis obliquus |
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| 中文摘要: |
| 目的：探讨不同限弧等速肌力训练对髌股关节炎患者髌骨轨迹的影响。方法：诊断为髌股关节炎患者60例，按接诊顺序分为A组（0°～30°）、B组（30°～60°）和C组（60°～90°）不同角度限弧运动训练组，每组各20例，采用德国ISOMED 2000等速肌力训练系统按分组对患者膝关节周围肌肉进行4周的限弧等速肌力训练。训练前、后拍摄膝关节负重正侧位及屈膝45°轴位片，测量髌骨轨迹参数（即髌股指数、外侧髌股角、髌骨合适角）；记录每个膝关节的等速肌力测定值，即峰力矩（PT）、总功（TW）及平均功率（AP）；采用西安大略和麦克马斯特大学骨关节炎指数（WOMAC）（包括疼痛、僵硬、日常功能）评定膝关节功能。结果：训练4周后，A组髌股指数、髌骨合适角较训练前明显降低，外侧髌股角较训练前明显提高(P<0.05)；A、B、C组峰力矩PT、总功TW及平均功率AP值均较训练前明显提高(P<0.05)；WOMAC评分比较，A组疼痛、日常功能评分较训练前明显降低(P<0.05)。训练后，髌骨轨迹参数比较：髌股指数、髌骨合适角A组明显低于B、C组(P<0.05)，外侧髌股角明显高于B、C组（P<0005）；等速肌力测定值比较：A组PT值明显高于B、C组(P<0．05)；WOMAC评分比较：疼痛评分A组明显低于B、C组(P<0.05)。B组与C组间各评分差异无统计学意义。结论：膝关节屈曲范围0°~30°的股四头肌等速训练可有效改善髌股关节炎髌骨轨迹，提高膝关节功能。 |
| 英文摘要: |
| Objective: To evaluate the effects of different quadrants of isokinetic quadriceps training on the mal-patellar tracking of patients with patellofemoral osteoarthritis. Methods: Isokinetic quadficeps training was administered to 60 cases of patellofemoral osteoarthritis. The subjects were allocated into 3 groups for 4 week isokinetie training with ranges of A (0-30°), B (30-60°) or C (60-90°)according to priority, with 20 knee joints in each group. X-rays with loading and with 45° knee flexion were taken before and after the training. The lateral patello femoral angle, the patella index and the patella femoral index were recorded along with the peak torque (PT), the total work (TW), and the average work (AW) in the three different ranges of motion. WOMAC scores were also recorded. Results: After 4-week training, the patellofemoral index and patellar proper angle in group A were significantly lower than those before training, and the lateral patellofemoral angle was significantly higher than before training. The difference was statistically significant (P<0.05); PT, TW and AW values in groups A, B, and C were significantly higher than before training (P<0.05); For WOMAC score comparison, the pain and daily function scores in group A were significantly lower than before training (P<0.05). After training, for the mal patellar tracking parameters comparison, the patellofemoral index and the appropriate patellar angle in group A were significantly lower than those in groups B and C (P<0.05), and the lateral patellofemoral angle was significantly greater than that in groups B and C (P<0.05); For comparison of measured values of isokinetic muscle strength, the PT in group A was significantly higher than that in groups B and C (P<0.05); For the comparison of WOMAC score, the pain score in group A was significantly lower than that in groups B and C (P<0.05). Conclusion: Isokinetic quadriceps training with 0°~30° range of motion can best realign patellar tracking of patellofemoral osteoarthritis, and improve knee function. |
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