等速肌力训练和传统肌力训练改善不完全脊髓损伤患者肌力和肌耐力的比较

A Comparative Study of Muscle Strength and Muscular Endurance in Patients with Incomplete Spinal Cord Injury Between Isokinetic Muscle Strength Training and Traditional Training

目的:观察等速肌力训练对不完全脊髓损伤(iSCI)患者股二头肌和股直肌肌力、肌耐力和6分钟步行距离(6MWT)的改善效果。方法:60例iSCI患者随机分为观察组和对照组,对照组给予徒手肌力训练和常规步行训练,观察组在此基础上增加等速肌力训练,共12周;于干预前后分别采集两组患者双侧股二头肌肌电积分值(BF-IEMG)、股直肌肌电积分值(RF-IEMG)、股直肌平均功率频率(RF-MPF)、股二头肌平均功率频率(BF-MPF)数据,同时评估6MWT结果。结果:12周干预结束后,两组患者上述指标均较干预前改善(P<0.01);与对照组相比,观察组BF-IEMG和RF-IEMG提高更多(P<0.01),BF-MPF和RF-MPF下降幅度低于对照组(P<0.05),6MWT增加更明显(P<0.05)。结论:与常规康复治疗相比,采用等速肌力训练能更有效的改善iSCI患者的膝关节肌群肌力、肌耐力和6MWT。

Objective: To observe the effect of 12-week isokinetic muscle strength training on biceps femoris (BF) and rectus femoris (RF) muscle strength,muscle endurance and ambulatory ability in 6-minute walk test (6MWT) in patients with incomplete spinal cord injury (iSCI). Methods: Sixty patients with iSCI in accordance with the inclusion criteria were randomly divided into two groups:the observation group (30 cases) and the control group (30 cases).Both groups received manual strength training,and conventional walking training,while the observation group carried out isokinetic training in addition.Participants were trained once a day,five times a week for twelve weeks.The curative effect was assessed by integrated electromyography (IEMG) of RF and BF,as well as Mean Power Frequency (MPF) of RF and BF and the ambulatory ability was detected using 6MWT.The evaluation was performed before the treatment and 12 weeks after the treatment. Results: In the end of rehabilitation,both groups showed significant improvement in IEMG,MPF and 6MWT( P< 0.01).The observation group exhibited significantly higher BF-IEMG and RF-IEMG compared with the control group( P <0.001).The MPF of BF and RF in the observation group were significantly lower than those in the control group( P <0.01).According to 6MWT,statistically significant improvement was observed in the treatment group( P <0.05). Conclusion: The modle of isokinetic muscle strength and muscular endurance training under the angular velocity of 60-90-120/180(°/s) can improve muscle strength and muscular endurance of knees as well as ambulatory function of patients with iSCI more effectively than traditional manual strength training.