血流限制性运动对前交叉韧带重建术后膝关节功能的影响
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摘要
目的探索前交叉韧带(ACL)重建术后进行血流限制性运动(BFR)训练对膝关节功能的影响。方法选取膝关节ACL断裂重建术后患者36例,按随机抽签法将患者分为观察组(n=18)和对照组(n=18)。两组患者均按照ACL重建术康复常规方案进行训练,观察组在常规训练的基础上每周增加2次BFR训练,连续3个月。两组患者分别进行膝关节Lysholm评分,等速肌力测试对股四头肌肌力和横截面积进行测量。结果经过3个月的康复治疗后,观察组Lysholm评分、等速肌力测试值及股四头肌横截面积较对照组升高,差异有统计学意义(P<0.05)。其中观察组等速肌力测试的伸膝峰力矩、H/Q比值、伸膝相对峰力矩较对照组显著增加(P<0.05);另外,股四头肌横截面积较对照组增大(P<0.05)。结论 BFR训练对膝关节ACL重建术后患者膝关节功能有显著改善作用,股四头肌肌力明显提高,为ACL重建术后的康复治疗提供新的思路。
Objective To explore the effect of blood flow restriction(BFR) training on knee function after the anterior cruciate ligament(ACL) reconstruction. Methods Thirty-six patients who after ACL reconstruction were randomly divided into two groups, treatment group and control group(n=18). All patients received the routine rehabilitation training program for ACL reconstruction. Meanwhile, the participants in treatment group received the BFR training twice weekly for three consecutive months. The Lysholm knee scores sale, strength and cross-sectional area of quadriceps muscle tested by isokinetic muscle strength test were compared.Results After 3 months of rehabilitation training, the Lysholm scores, and strength and cross-sectional area of quadriceps muscle in the treatment group were significantly increased compared with the control group(P<0.05). Conclusion BFR training can significantly improve knee function in patients after ACL reconstruction, enhance the quadriceps muscle strength.
Objective To explore the effect of blood flow restriction(BFR) training on knee function after the anterior cruciate ligament(ACL) reconstruction. Methods Thirty-six patients who after ACL reconstruction were randomly divided into two groups, treatment group and control group(n=18). All patients received the routine rehabilitation training program for ACL reconstruction. Meanwhile, the participants in treatment group received the BFR training twice weekly for three consecutive months. The Lysholm knee scores sale, strength and cross-sectional area of quadriceps muscle tested by isokinetic muscle strength test were compared.Results After 3 months of rehabilitation training, the Lysholm scores, and strength and cross-sectional area of quadriceps muscle in the treatment group were significantly increased compared with the control group(P<0.05). Conclusion BFR training can significantly improve knee function in patients after ACL reconstruction, enhance the quadriceps muscle strength.
引文
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[6] 吴博,张雷,庞文君,等.全身振动训练对前交叉韧带损伤重建术后患者下肢运动控制的影响[J].中国康复医学杂志,2016,31(4):421-425.
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[9] 许业灏,徐琳.血流限制性训练在低强度心脏康复训练中的应用进展[J].广东医学,2016,37(10):1575-1577.
[10] Counts BR,Dankel SJ,Barnett BE,et al.Influence of relative blood flow restriction pressure on muscle activation and muscle adaptation[J].Muscle Nerve,2016,53(3):438-445.
[11] Tennent DJ,Hylden CM,Johnson AE,et al.Blood Flow Restriction Training After Knee Arthroscopy:A Randomized Controlled Pilot Study[J].Clin J Sport Med,2017,27(3):245-252.
[12] Fry CS,Rasmussen BB.Skeletal muscle protein balance and metabolism in the elderly[J].Curr Aging Sci,2011,4(3):260-268.
[13] Heitkamp HC.Training with blood flow restriction.Mechanisms,gain in strength and safety[J].J Sports Med Phys Fitness,2015,55(5):446-456.
[14] Gundermann DM,Walker DK,Reidy PT,et al.Activation of mTORC1 signaling and protein synthesis in human muscle following blood flow restriction exercise is inhibited by rapamycin[J].Am J Physiol Endocrinol Metab,2014,306(10):1198-204.
[15] 刘根林,李建军,周红俊,等.肌力定量检查方法研究进展[J].中国康复理论与实践,2017,23(7):766-769.
[16] Loenneke JP,Young KC,Wilson JM,et al.Rehabilitation of an osteochondral fracture using blood flow restricted exercise:a case review[J].J Bodyw Mov Ther,2013,17(1):42-45.
[2] Brandner CR,Kidgell DJ,Warmington SA.Unilateral bicep curl hemodynamics:Low-pressure continuous vs high-pressure intermittent blood flow restriction[J].Scand J Med Sci Sports,2016,25(6):770-777.
[3] Segal NA,Williams GN,Davis MC,et al.Efficacy of blood flow-restricted,low-load resistance training in women with risk factors for symptomatic knee osteoarthritis[J].PMR,2015,7(4):376-384.
[4] 郭韵,高峰,杜良杰,等.膝关节镜下前交叉韧带重建术后膝关节功能康复研究进展[J].骨科,2016,7(6):465-469.
[5] 苏利强,黄红拾,常翠青.离心收缩训练对前交叉韧带断裂患者股四头肌萎缩影响的研究进展[J].中国康复医学杂志,2013,28(11):1067-1071.
[6] 吴博,张雷,庞文君,等.全身振动训练对前交叉韧带损伤重建术后患者下肢运动控制的影响[J].中国康复医学杂志,2016,31(4):421-425.
[7] Kerr ZY,Collins CL,Comstock RD.Epidemiology of weight training-related injuries presenting to United States emergency departments,1990 to 2007[J].Am J Sports Med,2010,38(4):765-771.
[8] 张其亮,丁利琼,滕学仁,等.膝关节前交叉韧带损伤后下肢肌力变化的等速测试研究[J].中国医学创新,2015,10(27):9-12.
[9] 许业灏,徐琳.血流限制性训练在低强度心脏康复训练中的应用进展[J].广东医学,2016,37(10):1575-1577.
[10] Counts BR,Dankel SJ,Barnett BE,et al.Influence of relative blood flow restriction pressure on muscle activation and muscle adaptation[J].Muscle Nerve,2016,53(3):438-445.
[11] Tennent DJ,Hylden CM,Johnson AE,et al.Blood Flow Restriction Training After Knee Arthroscopy:A Randomized Controlled Pilot Study[J].Clin J Sport Med,2017,27(3):245-252.
[12] Fry CS,Rasmussen BB.Skeletal muscle protein balance and metabolism in the elderly[J].Curr Aging Sci,2011,4(3):260-268.
[13] Heitkamp HC.Training with blood flow restriction.Mechanisms,gain in strength and safety[J].J Sports Med Phys Fitness,2015,55(5):446-456.
[14] Gundermann DM,Walker DK,Reidy PT,et al.Activation of mTORC1 signaling and protein synthesis in human muscle following blood flow restriction exercise is inhibited by rapamycin[J].Am J Physiol Endocrinol Metab,2014,306(10):1198-204.
[15] 刘根林,李建军,周红俊,等.肌力定量检查方法研究进展[J].中国康复理论与实践,2017,23(7):766-769.
[16] Loenneke JP,Young KC,Wilson JM,et al.Rehabilitation of an osteochondral fracture using blood flow restricted exercise:a case review[J].J Bodyw Mov Ther,2013,17(1):42-45.