膝骨关节炎患者居家康复训练后膝关节屈伸肌力的变化

Changes in knee flexion and extension muscle strength before and after home-based rehabilitation training in patients with knee osteoarthritis

目的:评估膝骨关节炎患者居家康复训练后膝关节屈伸肌力的变化。方法:前瞻性纳入2020年5月至2021年10月收治的50例单侧膝骨关节炎患者,均接受3个月居家康复训练(包括健康指导和功能训练)。居家康复训练前、训练3个月后应用Biodex等速测试系统分别在慢速60°/s等速、中速120°/s等速和90°等长模式下对患者进行双膝屈伸肌力测试,记录峰力矩,同时记录疼痛视觉模拟评分(VAS)及西安大略省和麦克马斯特大学骨关节炎指数(WOMAC)评分,并进行比较。结果:训练前,患者患侧60°/s等速、120°/s等速、90°等长屈膝、伸膝肌力均弱于健侧(P均<0.05)。训练3个月后,患者除健侧60°/s等速伸膝肌力无明显变化外(P=0.183),其余肌力均较训练前提高(P均<0.05);患者患侧60°/s等速、120°/s等速、90°等长伸膝肌力仍弱于健侧(P均<0.01),但屈膝肌力差异无统计学意义(P均>0.05)。训练3个月后,患者疼痛VAS评分、WOMAC评分均较训练前改善(P均<0.01)。结论:膝骨关节炎患者居家康复训练3个月后膝关节屈伸肌力明显增强,患侧与健侧屈膝肌力无明显差异,而伸膝肌力尚有差异,同时患者疼痛及膝关节功能明显改善。

Objective:To evaluate the changes in knee flexion and extension muscle strength before and after home-based rehabilitation training in patients with knee osteoarthritis.Methods:This prospective study enrolled 50 patients with unilateral knee osteoarthritis admitted between May 2020 and October 2021.Patients underwent 3 months of home-based rehabilitation training(including health guidance and functional training).Before and after 3 months of training,the Biodex isokinetic testing system was used to assess the bilateral knee flexion and extension muscle strength at slow speed(60°/s),medium speed(120°/s),and 90°isometric modes,respectively;peak torque(PT),visual analog scale(VAS),and Western Ontario and McMaster University osteoarthritis index(WOMAC)scores were recorded and compared.Results:Before training,knee flexion and extension muscle strength at 60°/s,120°/s,and 90°isometric was significantly weaker compared to the healthy side(P<0.05).After 3 months of training,all the muscle strength showed significant improvement(P<0.05),except for the 60°/s isokinetic knee extension muscle strength on the healthy side,which showed no significant change(P=0.183).Post-training,knee extension muscle strength at 60°/s,120°/s,and 90°isometric on the affected side remained weaker compared to the healthy side(all P<0.01),but no significant difference was observed in knee flexion muscle strength between the two sides(all P>0.05).Both VAS scores for pain and WOMAC scores showed significant improvement after 3 months of training(all P<0.01).Conclusions:Three months of home-based rehabilitation training significantly enhanced knee flexion and extension muscle strength in patients with knee osteoarthritis.Post-rehabilitation,the difference in flexion muscle strength between the affected and healthy sides was not significant,while the difference in extension muscle strength remained.Additionally,significant improvements were observed in patients'pain and knee joint function.