应用等速肌力测试评价膝前交叉韧带断裂重建术后康复的效果

Effect of Rehabilitation Program on the Isokinetic Muscle Power of Patients after Anterior Cruciate Ligament Reconstruction

目的:采用等速肌力测试系统测试前交叉韧带(ACL)断裂患者在重建术前、术后的肌肉力量,评价有、无严格的康复训练计划对患者康复效果的影响。方法:采用美国产Biodex System 3多关节等速肌力测试系统,以60°/s、120°/s两种速度测定67例膝关节前交叉韧带断裂及韧带重建术后6个月、12个月患者的股四头肌和腘绳肌肌力,包括峰力矩(PT)、峰力矩/体重比值(PT/BW)、总功(TW)、平均峰力矩(AVG PT)。将其中遵医嘱进行康复训练的24人作为康复训练组,另外无严格康复训练计划、自主活动的43人作为未康复训练组。结果:手术前患膝屈、伸肌群的PT、PT/BW、TW、AVG PT较健侧均显著降低;ACL重建术后6个月、12个月,两组患者股四头肌和腘绳肌肌力均较术前有所提高,其中未康复训练组患侧股四头肌肌力恢复至健侧70%左右,腘绳肌肌力恢复至健侧75%,康复训练组股四头肌和腘绳肌肌力分别恢复至健侧的80%和85%左右,高于未康复训练组,但与健侧相比仍有差距。结论:康复训练对ACL重建术后股四头肌和腘绳肌的肌力恢复有明显的作用。等速肌力测试是评价前交叉韧带重建术后康复效果的有效手段。

Objective To understand the influence of rehabilitation program on the muscle power of patients with anterior cruciate ligament（ACL）rupture before and after the reconstruction. Methods Muscle power including peak torque（PT）, peak torque/body weight（PT/BW）, total work（ TW）, average PT（APT） of quadriceps and hamstring of 67 patients with ACL rupture were assessed before and 6 ,and 12 months after reconstruction using Biodex system 3. The patients were divided into 2 groups. 24 were enrolled into rehabilitation program（RG） after surgery;and 43 had no specific rehabilitation plan（NRG）. Results Muscle power of quadrieeps and hamstring reduced obviously in injured knee before reconstruction. After 6 and 12 months of reconstruction, muscle power of quadriceps and hamstring was higher than that before reconstruction in both groups. The muscle power of quadriceps and hamstring reached nearly 70% and 75% of the uninjured side 6 and 12 months after reconstruction in NRG,respectively. However,the muscle power of quadriceps and hamstring reached nearly 80% and 85 % of the uninjured side respectively 6 and 12 months after reconstruction in RG. There was significant difference in muscle power between the two groups. Conclusion Rehabilitation is of importance for restoring muscle power of quadriceps and hamstring after ACL reconstruction.