膝骨关节炎患者临床症状与等速肌力测试指标的关系

Study on the relationship between clinical symptoms and isokinetic test indexes of myodynamia in patients with knee osteoarthritis

目的:探讨膝骨关节炎患者临床症状与等速肌力测试指标的关系。方法:纳入112例膝骨关节炎患者,先在3名经过培训的测评人员指导下,测定所有患者的西安大略和麦克马斯特大学骨关节炎指数,然后采用ISOMED-2000等速肌力测试系统分别测定患肢60(°)·s-1和180(°)·s-1时的屈伸膝峰力矩、相对峰力矩、峰功及相对峰功。对测得的西安大略和麦克马斯特大学骨关节炎指数及等速肌力测试指标进行Spearman相关性分析和多重线性回归分析。结果:Spearman相关分析结果显示,在伸膝指标方面,西安大略和麦克马斯特大学指数中的疼痛、僵硬、行动障碍及总分中的大部分指标均与60(°)·s-1和180(°)·s-1时的峰力矩、相对峰力矩、峰功及相对峰功呈负相关(P<0.05);在屈膝指标方面,西安大略和麦克马斯特大学指数中的疼痛、僵硬、行动障碍及总分中的大部分指标与60(°)·s-1和180(°)·s-1时的峰力矩、相对峰力矩、峰功及相对峰功均无相关性(P>0.05),仅有少部分临床症状指标与相对峰力矩、相对峰功呈负相关(P<0.05)。多重线性回归分析结果显示,60(°)·s-1时的伸膝相对峰功与西安大略和麦克马斯特大学骨关节炎指数中的疼痛评分、僵硬评分、行动障碍评分及总分均存在负线性关系(r=-0.271,P=0.001;r=-0.308,P=0.000;r=-0.263,P=0.001;r=-0.296,P=0.000);180(°)·s-1时的伸膝相对峰功与疼痛评分存在负线性关系(r=-0.214,P=0.010),180(°)·s-1时的伸膝峰功与僵硬评分存在负线性关系(r=-0.202,P=0.015)。结论:在等速肌力测试指标中,伸膝指标对膝骨关节炎患者临床症状的影响大于屈膝指标,其中60(°)·s-1时的伸膝相对峰功最能反映膝骨关节炎患者的临床症状,可将其作为定量评价膝骨关节炎患者临床症状的指标之一。

Objective：To explore the relationship between clinical symptoms and isokinetic myodynamia test indexes in patients with knee osteoarthritis（KOA）. Methods：One hundred and twelve patients with KOA were enrolled in the study. Western Ontario and McMaster Universities Osteoarthritis Index（WOMAC）scores were assessed with guidance from three trained evaluation staff. Peek torque,relative peek torque,peek power and relative peek power of knee extensors and flexors at 60° / sec and 180° / sec were measured by using an ISOMED-2000 isokinetic dynamomete. Then spearman correlation analysis and multiple linear regression analysis were applied to study the relation-ship between WOMAC and isokinetic myodynamia test indexes. Results：The results of spearman correlation analysis showed that most inde-xes of WOMAC were negatively correlated with peek torque,relative peek torque,peek power and relative peek power at 60° / sec and 180° / sec of knee extensors（p 〈 0. 05）,while they were uncorrelated for knee flexors（p 〉 0. 05）and only a few indexes of WOMAC were negatively correlated with relative peek torque and relative peek power（p 〈 0. 05）. The results of multiple linear regression analysis showed that relative peek power at 60° / sec of knee extensors was negatively linear correlated with pain scores,stiffness scores,handicap scores and total scores in WOMAC（r = ﹣ 0. 271,p = 0. 001;r = ﹣ 0. 308,p = 0. 000;r = ﹣ 0. 263,p = 0. 001;r = ﹣ 0. 296,p = 0. 000）,while relative peek power at 180° / sec of knee extensors was negatively linear correlated with pain scores（r = ﹣ 0. 214,p = 0. 010）and peek power at 180° / sec of knee extensor was negatively linear correlated with stiffness scores（r = ﹣ 0. 202,p = 0. 015）. Conclusion：Clinical symptoms are more influenced by knee extensor indexes than knee flexor indexes in patients with KOA in the isokinetic myodynamia test,and the rela-tive peek power at 60° / sec of knee extensor is the best index that can reflect the clinical symptoms in patients with KOA,so it can be used as one of the indexes for quantitative assessment of clinical symptoms in patients with KOA.