全髋关节置换患者下肢肌力变化与表面肌电特征的临床研究  

Effect of isokinetic exercises on surface electromyographic of patients after total hip replacement

作　　者：程凯[1] 李雪萍[1] 周俊[1] 杨婷[1] 于俊龙[1] 王黎明[2] 桂鉴超[2] 宋华荣[2] 

机构地区：[1]南京医科大学附属南京第一医院康复医学科,江苏南京210006 [2]南京医科大学附属南京第一医院骨科,江苏南京210006

出　　处：《中国现代医学杂志》2009年第8期1198-1201,共4页China Journal of Modern Medicine

基　　金：南京市医学科技发展项目(No:ZKM05036)

摘　　要：目的研究等速肌力训练对全髋关节置换术后患者表面肌电(sEMG)的影响和改善股四头肌及月国绳肌肌力的效果。方法16例全髋关节置换术后患者于术后14d开始行患侧多角度间歇等速肌力训练,选用60、90、120、90和600/s等5种角速度,每天1次。分别于第1次训练前、训练1周及2周后,测定下蹲过程中患肢与健肢股四头肌、月国绳肌的表面肌电信号,取中间的3次下蹲运动(包括蹲下和站起)的肌电积分值(iEMG值)进行分析,对比患侧与健侧肢体股四头肌、腘绳肌及月国绳肌/股四头肌比值(H/Q比率)的变化。结果训练前,患肢股四头肌、腘绳肌iEMG明显低于健侧,两组相比差异具有显著性(P<0.05);与训练前相比,训练后1周及2周后的患侧股四头肌、月国绳肌iEMG值均有明显提高(P<0.05);训练后健侧股四头肌、月国绳肌iEMG值有所降低(P<0.05);健侧H/Q比率则无显著变化(P>0.05)。结论等速肌力训练能有效改善全髋关节置换术后患者股四头肌及月国绳肌肌力,增加膝关节的稳定性。[Objective] To evaluate the strength of quadriceps femoris and hamstring muscles after isokinetic exercises by sEMG in patients with total hip replacement. [Methods] Fourteen days post operation, 16 cases started to do isokinetic exercises at 5 angle speeds in fit （60, 90, 120, 90 and 60 o/s） for two weeks on affected side. Integrated electromyogram （iEMG） was tested 3 times on quadriceps femoris and hamstring muscles of both affected and contralateral side before exercises, after one and two week-exercises. [Results] The iEMG value of quadriceps femoris and hamstring on affected side was lower than contralateral side before exercises. The iEMG value on affected side increased significandy and gradually closed to contralateral side after 1 and 2 weeks-exereises. The iEMG value of quadriceps femoris and hamstring on contralateral side decreased in all 3 tests. Significant changes of H/Q ratio were observed on affected side after 1 week and 2 week-exereises, at first decreased after 1 week-exercises and then increased after 2 week-exercises .No significant changes of H/Q ratio observed on contralateral side in all 3 tests. [Conclusions] lsokinetic exercises can improve the muscle strength of quadriceps femor/s and hamstrings ,and also improve the stability of knee joint in patients after total hip replacement.

关 键 词：全髋关节置换 等速肌力训练 表面肌电 肌力 

分 类 号：R684[医药卫生—骨科学]