膝关节骨关节炎患者等长、等速向心和等速离心测试的比较观察

The isometric concentric and eccentric strength of patients with knee osteoarthritis

目的评价膝关节骨关节炎(OA)患者患侧及健侧膝伸肌和屈肌在等长、等速向心和等速离心收缩时的功能特性及相互间的关系。方法应用Biodex system 3型等速测试系统对54例单侧膝OA患者进行患侧和健侧膝伸肌和屈肌的等长、等速向心及等速离心肌力测试。结果膝OA患者患侧膝关节伸肌和屈肌在不同收缩模式下的肌力均较健侧显著下降(P＜0．05),特别是在低速向心和低速离心收缩状态时的降低幅度尤为显著；同时患者的膝关节屈/伸肌肌力(H/Q)比值和动态控制率均提示其患侧肢体存在肌力平衡异常。结论在对膝OA患者肌肉功能进行评定时,应选用等速肌力测试并同时分析其H/Q比值及动态控制率,只有这样才能对患者的肌肉状况作出全面而客观的评定。

Objective To evaluate the functional changes in the isometric, concentric and eccentric muscle strength of the knee extensors and flexors in patients with knee osteoarthritis, and to explore the relationship among these contractions. Methods A Biodex System-3 isokinetic test system was used to assess the isometric, concentric and eccentric strength of the knee extensors and flexors of the involved and uninvolved limbs of 54 patients suffering from osteoarthritis. Results The strength of the knee extensors and flexors of the involved limbs was significantly less than that of the uninvolved legs in the different contraction modes （ P 〈 0.05 ）. The difference was especially marked in concentric and eccentric contraction at low angular velocity. The hamstrings/quadriceps ratio and the dynamic control ratio showed abnormalities in the muscle balance of the hamstrings and quadriceps. Conclusion Isokinetic testing should be applied and the hamstrings/quadriceps ratio and the dynamic control ratio should be analyzed in evaluating patients with knee osteoarthritis.