膝关节骨性关节炎等速离心收缩肌力的研究

A research on the eccentric strength of patients with knee osteoarthritis

目的评价单侧膝关节骨性关节炎(OA)患者患侧和健侧膝关节股四头肌和腘绳肌的向心收缩和离心收缩肌力的变化,重点研究膝OA股四头肌和腘绳肌离心收缩功能的变化。方法应用BiodexSystem-3型等速测试系统对42例单侧膝关节骨性关节炎患者进行患侧和健侧的股四头肌及腘绳肌的向心和离心收缩功能测试。结果患侧和健侧股四头肌及健侧腘绳肌向心收缩时,当速度增加,峰力矩值显著减小;离心收缩时,随着角速度增加峰力矩未见下降;相同速度下,患侧和健侧股四头肌和腘绳肌离心收缩肌力明显大于向心收缩;膝OA患者存在股四头肌向心收缩和离心收缩肌力的下降(P<0.05),肌力缺失百分比>10%,以及腘绳肌低速向心肌力下降(P<0.05),肌力缺失百分比为14.33%。膝OA股四头肌的离心/向心肌力比值(E/C比值)低于腘绳肌,随运动速度增加,股四头肌的E/C比值明显增大。患侧股四头肌60°/s角速度下的E/C比值较健侧有显著增高(P<0.05)。结论膝OA患者股四头肌存在向心和离心收缩功能异常,提示膝OA患者的肌肉功能测试应增加离心测试,并注意加强膝OA患者股四头肌的离心收缩训练。

Objective：To evaluate the functional change of concentric and eccentric contraction of quadriceps and hamstrings in patients with knee osteoarthritis. The special attention was paid to the function of eccentric contraction. Method： Biodex System-3 isokinetic test system was used to assess concentric and eccentric contraction of quadriceps and hamstring of involved and uninvolved limbs in 42 cases suffered from osteoarthritis. Result： In concentric contraction of both sides＇ quadriceps and uninvolved sides＇ hamstring,the peak torque tended to diminish as the angle velocity increasing,while peak torque leveled off in eccentric contraction. The eccentric contraction of both sides＇ quadriceps and hamstring produced significantly higher torques than concentric contraction did in same speed. The significant deficits in muscle strength of quadriceps were seen in involved limbs during maximal voluntary concentric and eccentric contraction（P〉0.05）,percentage deficits were greater than 10%,while significant deficits of hamstring were seen during low velocity concentric contraction（P〉0.05）, percentage deficits were 14.33%. Eccentric/concentric ratio of quadriceps in patients with knee osteoarthritis was lower than that of hamstring. Eccentric/ concentric ratio of quadriceps significantly increased as the angle velocity increased. Eccentric/concentric ratio of 60°/s of quadriceps of involved limbs was significantly higher than that of uninvolved limbs.Conclusion：Patients with knee OA have deficits in concentric and eccentric strength of quadriceps, which suggests that the muscle function test of patients with knee OA should include eccentric contraction test, and that patients with knee OA should enhance eccentric exercise of quadriceps.