易筋经功法干预膝骨关节炎患者步态生物力学的随机对照试验

Yijinjing exercise on gait biomechanics in patients with knee osteoarthritis:A randomized controlled trial

目的:比较易筋经功法与拉伸训练对膝骨关节炎(KOA)患者步态生物力学参数作用的差异。方法:自2020年9月至2021年4月从上海中医药大学附属岳阳中西医结合医院推拿科门诊等招募KOA患者50例,随机将患者按1∶1分为易筋经功法组和拉伸训练组。干预方式包括6周的线下课程训练和6周的居家自我练习。在入组基线时、干预结束后分别采集患者膝关节步态的运动学、动力学数据,进行组间统计分析。结果:功法组干预前后屈曲角度峰值、内收角度峰值、内收外展活动范围以及Z轴垂直地返力改善程度显著优于拉伸组(P<0.01,P<0.05)。结论:相较于拉伸训练,易筋经功法锻炼能够更显著地改善KOA患者关节活动范围,提高其步行能力;同时能够更显著地增加关节屈伸力矩、减小其内收力矩等参数。易筋经能够成为KOA患者运动治疗的传统功法选择,对于膝关节运动学、动力学的生物力学作用可能是其被应用治疗KOA的内在机制之一。

Objective:To compare the effects of Yijinjing exercises and stretching training on gait biomechanical parameters in patients with knee osteoarthritis(KOA).Methods:From September 2020 to April 2021,50 KOA patients were recruited from the outpatient clinic of the Tuina Department of Yueyang Integrated Traditional Chinese and Western Medicine Hospital affiliated to Shanghai University of Traditional Chinese Medicine,and the patients were randomly divided into YijinJing exercise group and stretching group according to 1:1.training group.The intervention method included 6 weeks of offline training and 6 weeks of home self-practice.Kinematics and kinetic data of knee joint gait were collected at baseline and at the end of the 12th week of intervention,respectively,and statistical analysis between groups was performed.Results:The improvement of flexion angle peak,adduction angle peak,adduction-abduction range of motion and Z-axis vertical return force before and after intervention in Yijinjing exercise group was significantly better than that in stretching group(P<0.01,P<0.05).Conclusion:Compared with stretching training,Yijinjing exercise can more significantly improve the range of motion of KOA joints and improve their walking ability;at the same time,it can more significantly increase the joint flexion and extension torque and reduce the adduction torque and other parameters.Therefore,Yijinjing can become the traditional exercise choice for KOA patients,and its biomechanical effect on knee kinematics and dynamics may be one of the internal mechanisms of its application to treatKOA.