肌力训练治疗老年膝关节骨性关节炎的疗效观察

Muscle strength training for elderly patients with knee osteoarthritis

目的:观察肌力训练治疗老年膝关节骨性关节炎(KOA)的临床疗效。方法:将138例老年KOA患者随机分为观察组和对照组各69例,观察组给予肌力训练治疗,对照组给予传统电针治疗。于治疗前后分别采用Lysholm膝关节评分标准评价膝关节功能,采用膝关节伸直位最大负荷量评价股四头肌肌力,采用静态平衡功能检测评价姿势稳定性。结果:治疗8周后,观察组除支撑外,其余各项Lysholm评分及总分均较治疗前明显提高(P<0.05);对照组跛行、交锁、膝软、疼痛、爬楼梯及Lysholm总分亦较治疗前显著改善(P<0.05);并且观察组交锁、膝软、疼痛、肿胀、爬楼梯、下蹲及Lysholm总分改善幅度均明显优于对照组水平(P<0.05)。2组患者膝关节伸直位最大负荷量均较治疗前明显改善(P<0.05),且观察组最大负荷量增加明显优于对照组水平(P<0.05)。2组患者睁眼及闭眼状态下静态平衡功能各项指标均较治疗前明显改善(P<0.05),且以观察组患者动揺轨迹长、矩形面积、外周面积及单位面积轨迹长的改善幅度显著优于对照组(P<0.05)。结论:肌力训练治疗能有效改善老年KOA患者膝关节及患肢肌肉功能,增强姿势稳定性。

Objective ：To investigate the therapeutic effects of muscle strength training for elderly patients with knee osteoarthritis .Methods：One hundred and thirty-eight patients with knee osteoarthritis were randomly divided into observation group and control group （n= 69 each） .The observation group was treated with muscle strength training ,and control group with electroacupuncture .Before and after treatment ,the motor function of their knee joints was evaluated according to Lysholm S knee scoring scale ,quadriceps muscle strength was evaluated according to the maximum load capacity of knee extension ,and postural stability was evaluated using a static balance function test .Results ：After 8 weeks of treatment ,Lysholm scores in observation group were significantly increased as compared with those before treatment （P〈0 .05） ,except for the item assessing supporting .There were significant differ-ences in the items assessing limp ,inter-locking ,instability ,pain and stair activity in control group before and after treatment（P〈0 .05） .There were significant differences in the items assessing inter-locking ,instability ,pain ,swell-ing ,stair activity and squatting between the two groups after treatment （P〈0 .05） .The maxi-inuill knee extension load was improved significantly in both groups（P〈0 .05） ,and more significantly in observation group than in control group（P〈0 .05） .Static balance with the eyes both open and closed was also improved significantly in both groups （P〈0 .05） .The length ,covered area ,rectangle area and length/area of the sway traces were improved more signifi-cantly in observation group（P〈0 .05） .Conclusions ：Muscle strength training can effectively improve knee function , quadrieeps muscle strength and postural stability in elderly patients with knee osteoarthritis .