臀肌挛缩症患者髋关节肌肉力量的生物力学研究  

Biomechanical Study of Hip Muscular Strength in Patients with Gluteal Muscle Contrature

作　　者：叶斌 陈友燕 张胜年[2] 马辉 余俊[3] 洪方业 张驰 孙伟 谢伟 陆阳洋 

机构地区：[1]上海市第一康复医院骨科,200090 [2]上海体育学院运动学院,200090 [3]安徽省蚌埠医学院研究生部,233000

出　　处：《中华全科医学》2012年第11期1674-1676,共3页Chinese Journal of General Practice

基　　金：上海市卫生局课题(沪卫科教2010-049-2-175)

摘　　要：目的通过对臀肌挛缩症患者髋关节屈伸、展收、旋转3组功能肌群进行等速向心肌力测试,比较分析臀肌挛缩症患者与正常人髋关节肌肉力量的差异特征,为临床治疗提供指导依据。方法研究对象为13名上海市第一康复医院臀肌挛缩症女性患者,以及13名上海体育学院运动人体科学专业女生(均无运动训练史),利用Contrex等速测力系统分别测试GMC患者术前髋关节屈伸(Flex/Ext)、展收(Abd/Add)、旋转(Ir/Er)3个功能轴肌群在向心60°/s角速度下的肌肉力量,并选取对峰力矩、相对峰力矩、最大功率与正常人进行比较。结果 GMC患者和正常人比较,GMC患者髋关节屈、外旋、外展肌群的力量均大于正常人。此外,GMC患者屈肌肌群最大功率[(68.39±17.74)～(71.66±19.49)]大于伸肌肌群最大功率[(55.90±20.75)～(58.6±25.46)],内旋肌群峰力矩(10.85±3.41)大于外旋肌群峰力矩(10.62±2.88),这和正常人的伸肌肌群最大功率[(69.62±21.89)～(70.99±23.72)]大于屈肌肌群最大功率[(67.78±13.73)～(68.71±12.24)],外旋肌群峰力矩(12.20±2.00)大于内旋肌群峰力矩(11.28±2.44)的特点相反。结论 GMC患者髋关节肌肉力量受到的影响主要表现在屈肌肌群、外旋肌群以及外展肌群肌肉力量发生代偿性增强,伸肌肌群力量较弱。[ Abstract] Objective Through isokinetic testing the afferent muscle strength of three groups of hip functional musculatures, to explore and compare the difference in the hip muscle strength between normal subjects and patients with gluteal muscle contrac- ture （ GMC ）, and provide a guidance for the clinical treatment. Methods The 13 female patients with GMC from Shanghai Yang- pu Geriatric Hospital and 13 female students from shanghai University of Sport（without the histort of exercise training） were en- rolled in this study. Contrex isokinetic dynamometer system was conducted to test the muscle strength at an angular velocity of 60 °/s of hip joint flexion and extension （ Flex/Ext）, abduction and adduction （ Abd/Add）, intorsion and extorsion rotation （Ir/Er） such three functional axis in patients with GMC before the operation and normal subjects. The peak torque, relative peak torque and maximum power were compared between the two groups. Results The hip joint Flex/Ext, Abd/Add and Ir/Er in patientswith GMC exceeded the values in normal subjects. In patients with GMC, their maximum power of flexor muscles [ （ 68.39 ＋ 17.74） - （71.66 ＋ 19.49） ] exceeded that of extensor muscles [ （55.90 -＋ 20.75 ） - （58.6 ＋ 25.46） ] ; their peak torque of in- ternal rotation muscle（ 10.85 ＋ 3.41 ） was greater than that of external rotation muscle（ 10.62 ＋ 2.88 ）. But in normal subjects, the maximum power of flexor muscles was （67.78 ＋-13.73 ） to （68.71 ＋ 12.24） ,less than that of extensor muscles [ （69.62 - 21.89 ） - （ 70.99 ＋ 23.72 ） ] ; the peak torque of internal rotation muscles was （ 11.28 ＋ 2.44 ）, less than that of external rotation muscles（ 12.20 ＋ 2.00）. Conclusion In patients with GMC, the muscle strengths of hip flexor muscles, external rotation mus- cles and abduction muscles are with compensatory increase, while these of extorsion muscle is weak.

关 键 词：臀肌挛缩症 等速测试 肌力矩 

分 类 号：R686[医药卫生—骨科学] R687.2[医药卫生—外科学]