80岁及以上膝骨性关节炎患者等速肌力与疼痛和功能状态的关系  

Association of isokinetic strength with pain and functional status in knee osteoarthritis patients aged 80 years and over

作　　者：瓮长水[1] 郭燕梅[1] 陈蔚[1] 黎春华[1] 王娜[1] 

机构地区：[1]解放军总医院南楼临床部康复医学科,北京100853

出　　处：《中华老年医学杂志》2014年第7期718-721,共4页Chinese Journal of Geriatrics

摘　　要：目的 评估80岁及以上膝骨性关节炎（OA）患者膝关节等速肌力与疼痛和功能状态之间的关系. 方法 32例膝OA患者和10例健康受试者作为对照组.对膝OA患者进行视觉模拟评分法（VAS）疼痛强度评分、Lequesne指数.对膝OA组和对照组受试者进行膝关节伸肌和屈肌标准化等速向心收缩测试程序,角速度为60°/s和180°/s,进行功能性移动能力测试：5次坐到站测试（FTSST）、3 m计时起立行走测试（TUGT）和10m计时步行测试（TWT）. 结果 膝OA组与对照组受试者在两个角速度的伸肌和屈肌的相对峰力矩之间的比较差异有统计学意义（t=2.747,P＜0.05）.伸肌相对峰力矩与年龄、Liquesce指数总分、FTSST、TUGT和TWT之间呈负相关（r=-0.39～-0.75,均P＜0.05）.伸肌相对峰力矩与VAS得分和Lequesne指数疼痛评分之间无相关（r=-0.23～ 0.31,均P＞0.05）.伸肌相对峰力矩和VAS得分两者是Liquesce指数的重要预测因子,可解释Liquesce指数41％的变异量（adjusted R2=0.41）. 结论 80岁及以上膝OA患者肌力损害程度与其功能表现密切关联,股四头肌肌力和疼痛强度是预测失能的重要指标.Objective To evaluate the difference in isokinetic strength of the knee muscles between knee osteoarthritis （KOA） patients aged 80 years and over and matched healthy controls,and to establish the association of isokinetic strength with pain and functional status in patients with KOA.Methods The study enrolled 32 patients aged 80 and over diagnosed with unilateral knee OA and 10 matched controls.Pain was evaluated by the visual analogue scale （VAS）,the pain intensity scale and the Lequesne index for patients with knee OA.Functional status was assessed by the Timed Up and Go Test （TUGT）,the Five Times Sit to Stand Test （FTSST） and the Timed 10 Meter Walk Test （TWT）.Muscle strength was measured using the isokinetic dynamometer Biodex System 4 Pro.Bilateral isokinetic （concentric） knee flexion and extension with the protocol of 60 degrees/sec,180 degrees/sec was also performed.Results The difference in two angular velocities of extensor and flexor peak torques between the knee OA group and the control group was statistically significant （t=2.747,P＜ 0.05）.The extensor peak torque was negatively correlated with age,Liquesce index scores,FTSST,TUGT and TWT （r=-0.39～～-0.75,P＜0.05）,but had no correlation with the VAS score or the Lequesne index pain score （r=-0.23～ 0.31,P＞0.05）.The regression analysis results suggested that the extensor peak torque and the VAS score together were important predictors for the Liquesce index （adjusted R2 =0.41）.Conclusions The degree of knee muscle damage is closely related to the functional performance of the muscles in knee OA patients aged 80 years or over.The strength of the quadriceps and the intensity of pain are important predictors of disability for those patients.

关 键 词：骨关节炎 膝 肌力 疼痛 

分 类 号：R684.3[医药卫生—骨科学]