内热针结合等速肌力训练对膝关节僵硬患者生物力学指标的影响
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摘要
目的:探讨内热针结合等速肌力训练对膝关节僵硬患者生物力学指标的影响。方法:将40例外伤导致的膝关节僵硬患者随机分为两组,治疗组20例采用内热针结合等速肌力训练治疗,对照组20例采用等速肌力训练治疗,分别记录两组患者治疗前后的膝关节活动度、Lysholm功能评分,以及治疗组患者伸/屈肌的峰力矩值、总功量值、平均功率,以及腘绳肌峰力矩/股四头肌峰力矩的变化,并进行统计学分析。结果:两组患者治疗后的膝关节活动度、Lysholm功能评分均较治疗前有所改善,差异均有统计学意义(P<0.05);且治疗组治疗后Lysholm功能评分的优良率明显高于对照组,差异有统计学意义(P<0.05);治疗组患者治疗后伸/屈肌的峰力矩值、总功量值、平均功率以及腘绳肌峰力矩/股四头肌峰力矩明显高于治疗前,差异均有统计学意义(P<0.05)。结论:采用内热针结合等速肌力训练治疗膝关节僵硬,能有效提高膝关节相关生物力学指标,改善关节功能。
Objective: To analyze the effect of inner-heat needle and isokinetic training on biomechanical indicators in patients with stiff knee. Methods: We collected 40 patients with stiff knee and divided then to 2 groups, 20 cases were treated with inner-heat needle and isokinetic training in treatment group, 20 cases only with isokinetic training in control group. Range of motion, and knee Lysholm index were observed and analyzed statistically in the patients of 2 groups before and after the treatments, and the peak torque, set total work, average power, H/Q of Extensor/Flexor group were observed and analyzed statistically in the patients of treatment group before and after the treatments. Results: After treatment, the range of motion of knee joint and Lysholm function scores of the two groups were improved, and the difference was statistically significant(P<0.05); after treatment, the excellent rate of Lysholm function score of the treatment group was significantly higher than that of the control group, the difference was statistically significant(P<0.05); after treatment, the peak torque value of extensor/flexor muscle, the total power value, the total power value of the treatment group were significantly higher than those before treatment(P<0.05). Conclusion: Using inner-heat needle and isokinetic training to treat stiff knee, can effectively improved the knee biomechanical indicators and achieved good clinical curative effect.
Objective: To analyze the effect of inner-heat needle and isokinetic training on biomechanical indicators in patients with stiff knee. Methods: We collected 40 patients with stiff knee and divided then to 2 groups, 20 cases were treated with inner-heat needle and isokinetic training in treatment group, 20 cases only with isokinetic training in control group. Range of motion, and knee Lysholm index were observed and analyzed statistically in the patients of 2 groups before and after the treatments, and the peak torque, set total work, average power, H/Q of Extensor/Flexor group were observed and analyzed statistically in the patients of treatment group before and after the treatments. Results: After treatment, the range of motion of knee joint and Lysholm function scores of the two groups were improved, and the difference was statistically significant(P<0.05); after treatment, the excellent rate of Lysholm function score of the treatment group was significantly higher than that of the control group, the difference was statistically significant(P<0.05); after treatment, the peak torque value of extensor/flexor muscle, the total power value, the total power value of the treatment group were significantly higher than those before treatment(P<0.05). Conclusion: Using inner-heat needle and isokinetic training to treat stiff knee, can effectively improved the knee biomechanical indicators and achieved good clinical curative effect.
引文
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[12]俞小杰,吴毅,白玉龙,等.等速向心和离心肌力训练治疗膝关节骨性关节炎患者的有效性研究[J].中国康复医学杂志,2007,22(11):986-988.
[13] Miller J P,Croce R V. Analyses of isokinetic and closed chain movements for hamstring reciprocal coactivation[J].J Sport Re-habil,2007,16(4):319-325.
[14]沈良册,杨秋红,吴玉玲,等.等速训练在股骨骨折制动后膝关节僵硬康复中的应用[J].中国康复理论与实践杂志,2012,18(2):162-164.
[2]国家中医重点专科膝关节僵硬协作组.膝关节僵硬中医诊疗方案[Z].2012.
[3]辛雷,苏佳灿.膝关节功能评分:现状与展望[J].中国组织工程研究与临床康复,2010,14(39):7367-7370.
[4]刘四海,崔志刚,刘克敏,等.创伤后膝关节僵硬的康复治疗[J].中华临床医师杂志(电子版),2012,6(4):1003-1005.
[5]崔志刚,刘四海,薛祖军,等.膝关节周围不同部位骨折致膝关节僵硬特点分析及早期康复疗效[J].中国康复理论与实践,2010,16(11):1005-1007.
[6]温莎,高谦,王刚,等.0.5 mm针径内热针密集针刺对家兔骨骼肌慢性损伤后肌张力的影响[J].中国康复医学杂志,2015,30(1):31-34.
[7]张文玉,高谦,王刚,等.内热针对大鼠软组织慢性损伤的影响[J].解放军医学院学报,2012,33(6):656-658.
[8]张文玉,高谦,王刚,等.软组织内热针对大鼠慢性损伤后血管内皮生长因子及内源性碱性成纤维细胞生长因子的影响[J].中华保健医学杂志,2012,14(3):193-196.
[9]杨志丽,高谦,王刚,等.软组织内热针对大鼠骨骼肌慢性损伤后血管新生的影响[J].解放军医学院学报,2010,31(12):1240-1242.
[10]高谦,王飞,杨志丽,等.银质针与软组织内热治疗仪对大鼠骨骼肌作用的实验研究[J].临床军医杂志,2009,37(5):758-760,943.
[11]郁可,范建中.等速技术原理及其在骨科康复中的临床应用[J].中华创伤骨科杂志,2010,7(2):172-173.
[12]俞小杰,吴毅,白玉龙,等.等速向心和离心肌力训练治疗膝关节骨性关节炎患者的有效性研究[J].中国康复医学杂志,2007,22(11):986-988.
[13] Miller J P,Croce R V. Analyses of isokinetic and closed chain movements for hamstring reciprocal coactivation[J].J Sport Re-habil,2007,16(4):319-325.
[14]沈良册,杨秋红,吴玉玲,等.等速训练在股骨骨折制动后膝关节僵硬康复中的应用[J].中国康复理论与实践杂志,2012,18(2):162-164.