等速肌力运动训练对膝关节骨关节炎患者择期关节置换术后预后的影响分析

Analysis of the influence of isokinetic muscle strength exercise training on the prognosis of knee osteoarthritis patients undergoing elective joint replacement

目的分析等速肌力运动对膝关节骨关节炎(knee osteoarthritis,KOA)患者择期关节置换术后预后的影响。方法选取2017年3月至2020年3月青岛市市立医院收治的100例KOA患者为研究对象,使用随机数字表法将入选患者按1~100编号,将奇数编号者纳入研究组,偶数编号者纳入对照组,每组各50例,所有患者均行择期关节置换术治疗并予常规术后功能锻炼指导。研究组患者在此基础上加用等速肌力运动训练,持续8周。对比两组患者术前、术后8周膝关节功能评分、等速肌力测试结果、膝关节活动度、疼痛评分。结果两组患者手术均顺利完成,随访时间8~17周,中位随访时间10周。术后8周,两组患者患侧膝关节Lysholm评分均显著高于本组术前(均P<0.05),患侧膝关节屈肌、伸肌60°/s、90°/s等速肌力测试峰值力矩(peak torque,PT)、总功量(total work,TW)、平均功率(average power,AP)、单次最大做功量(max rep total work,MRTW)及患侧膝关节屈曲度、屈伸弧度、伸直度均显著大于本组术前(均P<0.05),视觉模拟评分法(visual analogue scale,VAS)评分均显著低于本组术前(均P<0.05)。术后8周,研究组患者患侧膝关节Lysholm评分显著高于对照组(P<0.05),患侧膝关节屈肌、伸肌60°/s、90°/s等速肌力测试PT、TW、AP、MRTW及患侧膝关节屈曲度、屈伸弧度、伸直度均显著大于对照组(均P<0.05),VAS评分显著低于对照组(P<0.05)。结论与常规康复训练相比,接受择期关节置换术的KOA患者术后行等速肌力运动训练能够进一步改善膝关节功能,提高膝关节稳定性和活动度,减轻患者疼痛感。

Objective To analyze the influence of isokinetic muscle strength exercise training on the prognosis of knee osteoarthritis (KOA) patients undergoing elective joint replacement.Method A total of 100 patients with KOA admitted to Qingdao Muncipal Hospital from March 2017 to March 2020 were selected as subjects.The enrolled patients were numbered from 1 to 100 used random number table method.The odd-numbered patients were included in study group,and the even-numbered patients were included in control group,with 50 cases in each group.All patients were treated with elective joint replacement and given routine postoperative functional exercise guidance.Patients in study group added isokinetic muscle strength exercise training for 8 weeks.The results of knee function score,isokinetic muscle strength test,the changes of knee range of motion and pain score were compared between the two groups before and 8 weeks after operation.Result The operations of patients in both groups were successfully completed,and the follow-up time was 8 to 17 weeks,with a median follow-up time of 10 weeks.Eight weeks after operation,the Lysholm scores of the affected side knee joint of the two groups were significantly higher than those before operation (all P<0.05),the peak torque (PT),total work (TW),average power (AP),max rep total work (MRTW) of the 60°/s and 90°/s isokinetic muscle strength tests of the flexor and extensor of the affected side knee joint and the flexion,flexion and extension radians and straightness of the affected side knee joint were significantly larger than those in this group before operation (all P<0.05),the visual analogue scale (VAS) score were significantly lower than those in this group before operation (all P<0.05).Eight weeks after operation,the Lysholm score of the affected side knee joint in study group was significantly higher than that in control group (P<0.05),the PT,TW,AP,MRTW of the 60°/s and 90°/s isokinetic muscle strength tests of the flexor and extensor of the affected side knee joint and the flexion,flexion and extension radians and straightness of the affected side knee joint were significantly larger than those in control group (all P<0.05),the VAS score was significantly lower than that in control group (P<0.05).Conclusion Compared with conventional rehabilitation training,isokinetic muscle strength exercise training can further improve the knee function in patients with KOA undergoing elective joint replacement,improve the stability and range of motion of the knee,and reduce the pain.