本体感觉神经肌肉促进技术对膝骨关节炎患者本体感觉及平衡能力的影响

Proprioceptive neuromuscular facilitation can improve the proprioception and balance of persons with osteo- arthritis of the knee

目的 探讨本体感觉神经肌肉促进（PNF）技术训练对膝骨关节炎（KOA）患者膝关节本体感觉及平衡能力的影响。 方法 选取符合入组标准的KOA患者40例，按随机数字表法分为实验组和对照组，每组20例。实验组接受PNF技术锻炼，包括等张组合、节律性稳定和动态逆转技术；对照组接受规范的患侧股四头肌肌力训练。采用膝关节再成角试验评估本体感觉，采用单腿站立测试（OLS）和5次坐立试验（FTSST）评估患者的平衡能力。 结果 实验组治疗前后的膝关节30°、60°、110°主动成角误差与被动成角误差差异有统计学意义（P〈0.05），对照组治疗前后的膝关节各角度主动成角误差与被动成角误差差异无统计学意义（P〉0.05）。治疗后，实验组的膝关节各角度主动成角误差及被动成角误差明显小于对照组治疗后（P〈0.05）。实验组治疗后的OLS与FTSST时间亦明显优于组内治疗前（P〈0.05）；但对照组治疗后的OLS时间与治疗前相比，差异无统计学意义（P〉0.05），而FTSST时间明显短于组内治疗前（P〈0.05）。实验组治疗后的OLS与FTSST时间明显优于对照组治疗后（P〈0.05）。 结论 PNF技术可显著改善KOA患者膝关节本体感觉及平衡能力。

Objective To explore any effect of proprioceptive neuromuscular facilitation （PNF） on the proprioception and balance of patients with knee osteoarthritis （KOA）. Methods Forty patients with KOA were randomly divided into an experimental group （EG） and a control group （CG）, each of 20. The PNF techniques of isotonic combined contraction, and rhythmic stable and dynamic reversal were applied in the EG, while the CG received quadriceps muscle strength training. Knee proprioception was evaluated using knee angle reconstruction experiments, and balance ability was measured using the one leg standing test （OLS） and the five times sit to stand test （FTSST）. Results The errors in active and passive knee angle reconstruction at 30°, 60° and 110° all improved significantly in the EG, but not in the CG. After the treatment, the OLS and FTSST results improved significantly in the EG, but only the OLS results improved significantly in the CG, not the FTSST times. Even so, the average OLS time in the EG was significantly longer than that of the CG after the training. Conclusion Proprioceptive neuromuscular facilitation can improve the proprioception and balance of persons with knee osteoarthritis.