等速结合本体感觉训练治疗膝骨性关节炎患者的临床疗效研究

Clinical Efficacy of Isokinetic Combined with Proprioceptive Training in the Treatment of Knee Osteoarthritis

目的:探究等速运动结合本体感觉训练对膝骨性关节炎患者膝关节屈伸肌力量、协调性及肢体平衡功能的影响。方法:选取在青岛滨海学院附属医院康复医学科接受康复治疗的60例膝骨性关节炎患者为研究对象。采用随机数字表法分为三组,各20例,A组采取物理因子治疗与常规运动治疗,B组采取物理因子治疗与等速向心结合离心肌力训练治疗,C组在B组基础上加本体感觉训练。采用等速测试仪测量治疗前后的峰值力矩(PT)、屈伸肌力比值(H/Q)及主动角度重现测试值(AAR);平衡训练仪检测治疗前后的评估完成耗时(Time)及平均轨迹误差(ATE);并用VAS、WOMAC量表分别评价治疗前后膝关节疼痛与生活质量。结果:三组患者训练后的等速指标、动态平衡指标、VAS及WOMAC都显著改善(P<0.05)。治疗后PT、H/Q两两比较,C=B>A;AAR与Time组间差异明显(P<0.05),C>B>A。治疗后ATE值两两比较,C>B=A。VAS评分与WOMAC评分治疗后组间比较有统计学意义(P<0.05),C>B>A。三组患者治疗期间均无不良反应发生。结论:等速运动结合本体感觉训练能够降低膝骨性关节炎患者疼痛,增强膝关节屈伸肌肌力与协调性,改善膝关节平衡功能。

Objective:To explore the effect of isokinetic exercise combined with proprioceptive training on knee flexion and extensor strength,coordination and limb balance function in patients with knee osteoarthritis.Methods:60 patients with knee osteoarthritis were selected from the Department of Rehabilitation Medicine,Qingdao Binhai University affiliated Hospital.The patients were randomly divided into 3 groups(n=20).Group A was treated with physical factor therapy and routine exercise therapy,group B was treated with physical factor therapy and isokinetic concentric combined eccentric muscle strength training,and group C was treated with proprioceptive training on the basis of group B.The peak torque(PT),the ratio of flexion to extensor force(H/Q)and the active angle reappearance value(AAR)were measured by isokinetic tester before and after treatment;balance training instrument was used to measure the time-consuming(Time)and average trajectory error(ATE)before and after treatment;knee joint pain and quality of life were evaluated with VAS and WOMAC scale before and after treatment.Results:After training,the isokinetic index,dynamic balance index,VAS and WOMAC were significantly improved in the three groups(P<0.05).Pairwise comparison of PT and H/Q after treatment,C=B>A.There were significant differences between groups of AAR and Time(P<0.05),C>B>A.After treatment,the ATE value was pairwise compared,C>B=A.The comparison between groups was statistically significant of VAS score and WOMAC score after treatment(P<0.05),C>B>A.There were no adverse reactions in the three groups during the treatment period.Conclusion:Isokinetic concentric combined eccentric training can reduce the pain of patients with knee osteoarthritis,enhance the muscle strength and coordination of knee flexion and extensor,and improve the function of knee joint.