血流限制训练对前交叉韧带重建术患者股四头肌及膝关节稳定性的影响

The effects of blood flow restriction on the quadriceps femoris and knee stability after anterior cruciate liga-ment reconstruction

目的观察血流限制训练对前交叉韧带(ACL)重建术患者股四头肌及膝关节稳定性的影响。方法将40例ACL重建术患者按随机数字表法分为对照组和治疗组,每组20例。2组患者均给予常规康复干预,对照组增加常规膝关节屈伸肌力训练,治疗组增加血流限制训练,在腹股沟部保持恒定的压力以限制下肢的血液流动,血流限制压力设置为个体动脉闭塞压的70%,平均压力为(123.00±11.23)mmHg,训练内容包括膝关节屈伸抗阻训练和伸膝抗阻训练,每次20 min,每周3次,共训练8周。分别于治疗前和治疗8周后(治疗后),采用Lysholm量表评估膝关节功能、Humac Norm等速测试仪评估屈伸肌峰力矩比值(H/Q%)和伸膝肌峰力矩(PT)。结果治疗前,2组患者的Lysholm评分、H/Q%、PT组间比较,差异均无统计学意义(P<0.05);治疗后,2组患者的Lysholm评分、H/Q%、PT均较组内治疗前显著改善(P<0.05),且治疗组患者的Lysholm评分[(84.65±2.43)分]、H/Q%[(55.45±6.21)%]、PT[(115.25±10.32)N·m]均明显优于对照组治疗后[(82.15±4.49)分、(41.75±4.45)%、(104.45±8.52)N·m],组间差异均有统计学意义(P<0.05)。结论血流限制训练能有效地改善ACL重建术患者的股四头肌力量、膝关节稳定性及膝关节功能。

Objective To explore the effect of blood flow restriction training on the quadriceps femoris and on knee stability after anterior cruciate ligament reconstruction.Methods Forty patients recovering from anterior cruciate ligament reconstruction were randomly divided into an experimental group and a control group,each of 20.In addition to routine rehabilitation training,the control group was given routine knee flexion and extension strength training,while the experimental group trained for an additional 20 minutes doing knee flexion and extension resistance training with the blood pressure in their groins at 70%of their individual arterial occlusive pressure.(The mean pres-sure was(123±11.23)mmHg).The training lasted 8 weeks,three times a week.Knee function and hamstring and quadriceps peak torque were assessed before and after the intervention using a Lysholm scale and Humac Norm isoki-netic muscle strength tests.Results There were no significant differences between the two groups in any of the measurements before the training.After the intervention,all of the measurements had improved significantly in both groups,with the average Lysholm score,H/Q%and peak torque of the experimental group significantly better than the control group′s averages.Conclusions Blood flow restriction training can improve the effectiveness of quadri-ceps femoris strength,knee stability and knee function training after anterior cruciate ligament reconstruction.