不同角度股四头肌等速肌力训练对骨科术后康复治疗疗效的影响研究

A research on the influence of isokinetic muscle strength training for quadriceps of different angles on the curative effect of post-operative rehabilitation treatment of orthopedic surgery

目的:分析不同角度股四头肌等速肌力训练对骨科术后康复治疗疗效的影响。方法:选取在医院行骨科手术和康复治疗的100例骨骼疾病患者,按照患者的等速肌力训练的角度将其分为0°～30°组(34例)、31°～60°组(32例)和61°～90°组(34例)。给予三组患者相应角度的股四头肌等速肌力训练,比较三组患者的股四头肌肌力和腘绳肌、胫前肌及小腿三头肌肌力以及步态。结果:三组患者的股四头肌肌力比较,31°～60°组患者的等速肌力测定指标明显高于0°～30°组和61°～90°组患者,其差异有统计学意义(F=6.33,F=4.71,F=5.82,F=6.02,F=6.11,F=5.76,F=4.94;P<0.05),0°～30°组患者与61°～90°组患者等速肌力测定峰力矩等7项指标比较,其差异无统计学意义(t=2.442,t=0.597,t=1.101,t=1.457,t=0.859,t=0.783,t=0.123;P>0.05)。三组患者的小腿三头肌肌力比较,0°～30°组患者的等速肌力测定指标明显高于31°～60°组和61°～90°组患者,其差异有统计学意义(F=4.41,F=4.97,F=5.20,F=4.98,F=6.17,F=5.94,F=5.49;P<0.05),31°～60°组患者与61°～90°组患者的等速肌力测定峰力矩等7项指标比较,其差异无统计学意义(t=0.917,t=0.848,t=0.789,t=1.490,t=1.794,t=0.755,t=0.819;P>0.05)。0°～30°组患者的步态参数优于31°～60°组和61°～90°组患者,其差异有统计学意义(F=5.18,F=4.88,F=4.76,F=5.52,F=5.06,F=6.17;P<0.05),31°～60°组患者与61°～90°组患者的支撑相初期等6项步态参数比较,其差异无统计学意义(t=1.971,t=2.762,t=0.814,t=1.133,t=1.313,t=1.027;P>0.05)。结论:不同角度的股四头肌等速肌力训练能够有效促进骨科手术患者的康复,其中以31°～60°范围内的股四头肌等速肌力训练效果最为显著。

Objective To analyze the influence of isokinetic muscle strength training for the quadriceps of different angles on the curative effect of postoperative rehabilitation treatment of orthopedic surgery. Methods： 100 patients with bone disease who were receiving orthopedic surgery and rehabilitative treatment were enrolled in the research, and all of them were divided into 0°-30°group （34 cases）, 31-60° group （32 cases） and 61°-90°group （34 cases） according to different angle of isokinetic muscle strength training. The patients of each group received different isokinetic muscle strength training for quadriceps as corresponding angle. And then the gait and muscle strengths of quadriceps, hamstring muscle, tibialis anterior muscle and triceps surae of three groups were compared and analyzed. Results： For the comparisons of quadriceps strength among three groups, the seven isokinetic muscle strength determination indexes of 31°-60°group were significantly higher than that of other two groups （F=6.33, F=4.71, F=5.82, F=6.02, F=6.11, F=5.76, F=4.94, P〈0.05）, respectively, while for the same seven indexes, there were no significant difference between 0°-30°group and 61°-90°group （t=2.442, t=0.597, t=1.101, t=1.457, t=0.859, t=0.783, t=0.123, P〉0.05）, respectively. For the comparisons of triceps surae strength among three groups, the seven isokinetic muscle strength determination indexes of 0°-30°group were significantly higher than that of other two groups （F=4.41, F=4.97, F=5.20, F=4.98, F=6.17, F=5.94, F=5.49, P〈0.05）, respectively, while for the same seven indexes, there were no significant difference between 31°-60°group and 61°-90°group （t=0.917, t=0.848, t=0.789, t=1.490, t=1.794, t=0.755, t=0.819, P〉0.05）, respectively. The gait parameters of 0°-30°group were significantly better than that of other two groups（F=5.18, F=4.88, F=4.76, F=5.52, F=5.06, F=6.17, P〈0.05）, respectively, while for the same 6 gait parameters indexes, there were no significant difference between 31°-60° group and 61°-90°group （t=1.971, t=2.762, t=0.814, t=1.133, t=1.313, t=1.027, P〉0.05）, respectively. Conclusion： Isokinetic muscle strength training for the quadriceps of different angles can effectively promote the rehabilitation of patients who undergo operation of orthopedics department. And when the range of angle is from 31° to 60°, the effect of quadriceps isokinetic muscle strength training is the most significant.