不同养生功法在膝骨关节炎患者中的对比研究

A Comparative Study of Different Health Maintenance Methods in Patients with KOA

目的:观察太极拳、八段锦、五禽戏在膝骨关节炎(KOA)患者中的干预效果。方法:纳入KOA患者165位,随机分为太极拳组、八段锦组、五禽戏组各55人,各组功法要求每周练习3次,每次30~40 min。练习前和练习12周后,采集3组患者的视觉模拟评分(Visual Analogue Scale/Score,VAS)、Lequesne指数、关节活动度重现偏差度、股四头肌和腘绳肌的积分肌电值(iEMG)、稳定极限范围(LOS)以及起立-走测试、强化Romberg测试数据。结果:干预结束后3组比较,在VAS方面,3组间无统计学意义。而在Lequesne指数方面,太极拳组低于八段锦组和五禽戏组,差异有统计学意义(P<0.05);而八段锦组和五禽戏组相比,差异无统计学意义。在本体感觉方面,在0°~40°区间,太极拳组低于八段锦组和五禽戏组,差异有统计学意义(P<0.05);而八段锦组和五禽戏组相比,差异无统计学意义。在40°~80°和80°~120°区,太极拳组均低于八段锦组和五禽戏组,差异有统计学意义(P<0.05),而五禽戏组均低于八段锦组,差异有统计学意义(P<0.05)。在肌力方面,股四头肌iEMG 3组间无统计学意义。而在腘绳肌iEMG太极拳组与五禽戏组高于八段锦组,差异有统计学意义(P<0.05);而太极拳组和五禽戏组相比,差异无统计学意义。在平衡测试方面,LOS面积,干预后太极拳组高于五禽戏组和八段锦组,差异有统计学意义(P<0.05);而八段锦组与五禽戏组差别无意义。在起立-走测试和强化Romberg测试,太极拳组均优于五禽戏组和八段锦组,差异有统计学意义(P<0.05)。结论:在太极拳、八段锦、五禽戏干预KOA患者的横向比较中,24式太极拳不仅能够提高膝关节屈伸肌肌力、缓解疼痛,还能更加有效地增强关节本体感觉和平衡能力,其功能改善情况优于八段锦、五禽戏,值得进一步推广和应用。

Objective:To observe the intervention effects of Taijiquan,Baduanjin and Wuqinxi in patients with knee osteoarthritis.Methods:Collected 165 KOA patients and randomly divided them into Taijiquan group,Baduanjin group,and Wuqinxi group,each with 55 people.Each group was required to practice the exercises 3 times a week,30~40 minutes each time.Before and after 12 weeks of exercise,collected the VAS scores,Lequesne indexes,recurrence deviation of joint mobility,quadriceps and hamstrings’integrated electromyography(iEMG),and stability limit(LOS)of the 3 groups of patients.As well as stand-to-go test,strengthen Romberg test data.Results:Comparing the three groups after the intervention,in terms of VAS,there was no statistical significance among the three groups(P>0.05).In terms of Lequesne index,the Taijiquan group was lower than the Baduanjin group and the Wuqinxi group,the difference was statistically significant(P<0.05);while the Baduanjin group and the Wuqinxi group had no statistically significant difference(P>0.05).In terms of proprioception,in the range of 0°-40°,the Taijiquan group was lower than the Baduanjin group and the Wuqinxi group,the difference was statistically significant(P<0.05);when the Baduanjin group was compared with the Wuqinxi group,the difference was not statistically significant(P>0.05).In the 40°-80°and 80°-120°areas,the Taijiquan group was lower than the Baduanjin group and the Wuqinxi group,the difference was statistically significant(P<0.05),while the Wuqinxi group was lower than the Baduanjin group Group,the difference was statistically significant(P<0.05).In terms of muscle strength,there was no statistical significance among the quadriceps femoris iEMG3 groups(P>0.05).But in the hamstring muscle iEMG Taijiquan group and Wuqinxi group were higher than the Baduanjin group,the difference was statistically significant(P<0.05);while the difference between the Taijiquan group and the Wuqinxi group was not statistically significant(P>0.05).In terms of both balance test and LOS area,the Taijiquan group was higher than the Wuqinxi group and the Baduanjin group after the intervention,the difference was statistically significant(P<0.05);while the difference between the Baduanjin group and the Wuqinxi group was not significant(P>0.05).In the standing-walking test and the reinforced Romberg test,the Taijiquan group was better than the Wuqinxi group and the Baduanjin group,and the difference was statistically significant(P<0.05).Conclusion:In the horizontal comparison of Taijiquan,Baduanjin,and Wuqinxi interventions in KOA patients,24-style Taijiquan can not only improve knee flexor and extensor muscle strength,relieve pain,but also enhance joint proprioception and balance more effectively.Taijiquan is better in improving joint functions than Baduanjin and Wuqinxi,and is worthy of further promotion and application.