等速肌力训练对改善膝骨关节炎肌肉功能的Meta分析

Meta-analysis of isokinetic muscle strength training for improving muscle function in knee osteoarthritis

目的:系统评价等速肌力训练对改善膝骨关节炎肌肉功能的临床疗效。方法:计算机检索2008年8月至今CNKI、维普、万方、PubMed等数据库,搜集等速肌力训练改善膝骨关节炎肌肉功能的随机对照试验。对纳入文献进行筛选,资料提取,质量评价和风险评估后,采用RevMan 5.3软件进行Meta分析。结果:共纳入研究10项,样本量718例,等速肌力训练在改善膝关节功能评分(Lysholm Knee Scoring Scale,LKSS)(MD=9.41,95%CI[5.63,13.19],Z=4.88,P<0.05),伸肌群峰力矩PT(MD=20.31,95%CI[8.48,32.15],Z=3.36,P<0.05)、屈肌群峰力矩PT(MD=14.32,95%CI[3.37,25.27],Z=2.56,P=0.01)、VAS评分(MD=-0.64,95%CI[-1.20,-0.08],Z=2.24,P=0.02)、伸肌群TW(MD=86.63,95%CI[42.48,130.77],Z=3.85,P<0.05)、屈肌群TW(MD=57.85,95%CI[38.07,77.63],Z=5.73,P<0.05)等反映肌肉功能的直观指标方面均优于对照组。结论:等速肌力训练在一定程度上可以改善患者肌肉功能。但因纳入文献数量有限,上述确切结论仍需开展大样本高质量的RCT加以验证。

Objective:To investigate the clinical effect of isokinetic muscle strength training on improving muscle function in knee osteoarthritis.Methods:The CNKI,VIP,Wanfang and PubMed databases were searched by computer from August 2008 till now,and randomized control trials(RCTs)on isokinetic muscle strength training which could improve muscle function in KOA were selected.After screening,data extraction,quality evaluation and risk assessment,meta-analysis was carried out with RevMan 5.3 software.Results:A total of 10 studies were included,and there were 718 cases.Isokokinetic muscle training could improve muscle function better than the control group,such as LKSS score(MD=9.41,95%CI[5.63,13.19],Z=4.88,Z=4.88,P<0.05),LKSS score(MD=9.41,95%CI[5.63,13.19],Z=4.88,Z=4.88,P<0.05),extensor peak torque(MD=20.31,95%CI[8.48,32.48,32.15],Z=3.36,P<0.05,P<0.05),flexor peak torque(MD=14.32,95%CI 95%CI[3.32,95%]CI[3.3764,95%]CI[-1.20,-08],Z=2.24,P=0.02),extensor total work(MD=86.63,95%CI[42.48,130.77],Z=3.85,P<0.05),flexor total work(MD=57.85,95%CI[38.07,77.63],Z=5.73,P<0.05).Conclusion:Isokinetic muscle strength training can improve the muscle function to a certain extent.However,due to the limited number of literatures included,the exact conclusions still need to be verified by RCTs with large samples and high quality.