基于等速肌力测试探究电针治疗老年膝骨关节炎对下肢肌力的影响研究

A study on effects of electroacupuncture treatment on lower limb muscle strength in elderly patients with knee osteoarthritis based on isokinetic muscle strength test

目的基于等速肌力测试观察比较电针治疗老年膝骨关节炎(KOA)的临床疗效,分析电针治疗对于改善老年KOA引起对下肢肌力的影响。方法选取2021年1月—2023年5月就诊于复旦大学附属华东医院针灸科及康复医学科患者采用G-power 3.1.9.7软件进行最小样本量计算得36例,按照随机数字表法分为电针组和对照组,每组18例。电针组采用电针疗法,对照组采用常规康复训练,每周3次,持续干预8周,用WOMAC评分、等速肌力测试屈伸肌力测试和动肌与拮抗肌峰力矩比,对2组干预前后进行评估。结果WOMAC评分:电针组和对照组WOMAC评分在疼痛、僵硬、关节功能及总分方面较干预前均出现好转(P<0.05),且电针组在疼痛、僵硬、关节功能及总分方面均明显优于对照组(P<0.05);峰力矩(PT值)结果:电针组在各角速度下伸屈肌的PT值较干预前均出现好转(P<0.05),组间比较无明显差异(P>0.05),其差值比较电针组优于对照组(P<0.05);主动肌与拮抗肌峰力矩比值(H/G值)结果:2组不同角速度下H/G值均无明显变化(P>0.05)。结论电针治疗能改善KOA患者膝关节屈伸肌肉力量,从而恢复膝关节周围肌群的生物力学平衡,提升膝关节的稳定性。

Objective To observe the clinical efficacy of electroacupuncture in the treatment of elderly knee osteoarthritis(KOA)based on isokinetic muscle strength test,and analyze the impact of electroacupuncture treatment on improving lower limb muscle strength caused by elderly KOA.Methods The patients who were admitted to Department of Acupuncture and Rehabilitation Medicine of Huadong Hospital Affiliated to Fudan University from January 2021 to May 2023 were selected.The minimum sample size was calculated by G-power 3.1.9.7 software,and 36 cases were obtained.They were divided into electroacupuncture group and control group according to random number table method,with 18 cases in each group.The electroacupuncture group received electroacupuncture therapy,while the control group received routine rehabilitation training.Both groups received treatment three times a week and continued intervention for 8 weeks.Before and after intervention,WOMAC scores,isokinetic muscle strength tests for flexor and extensor muscles,and peak torque ratio between active muscle and antagonist muscle were measured and compared between the two groups.Results WOMAC scores:Compared with before intervention,WOMAC scores of both groups were improved in terms of pain,stiffness,joint function and total score(P<0.05),and the electroacupuncture group was significantly better than the control group in terms of pain,stiffness,joint function and total score(P<0.05).Peak torque(PT value):The PT value of the extensor and flexor muscles in the electroacupuncture group showed improvement at various angular velocities compared to before intervention(P<0.05),and there was no significant difference between the two groups(P>0.05),but the difference before and after intervention was larger in the electroacupuncture group than that in the control group(P<0.05).Peak torque ratio(H/G value)between active muscle and antagonist muscle:There was no significant change in H/G value at different angular velocities in both groups(P>0.05).Conclusions Electroacupuncture therapy can improve the strength of flexor and extensor muscles in KOA patients,thereby restoring the biomechanical balance of the muscles around the knee joint and improving the stability of the knee joint.