髋周肌群力量训练对功能性踝关节不稳的疗效及表面肌电评价  

Effect of Strength Training of Hip Muscles on Functional Ankle Instability:Evaluated with Surface Electromyography

作　　者：张梅莹[1] 赵蕾[1] 李慧 王颖颖[2] 戴世友[1] ZHANG Mei-ying;ZHAO Lei;LI Hui;WANG Ying-ying;DAI Shi-you(Department of Osteoarthrology and Sports Medicine,Qingdao Municipal Hospital,Qingdao,Shandong 266000,China;Department of Rehabilitation Medicine,Qingdao Municipal Hospital,Qingdao,Shandong 266000,China;Ultrasound Department,the Second Maternal and Child Health Care Hospital,Ji'nan,Shandong 250000,China)

机构地区：[1]青岛市市立医院东院区骨关节与运动医学科,山东青岛市266000 [2]青岛市市立医院东院区康复医学科,山东青岛市266000 [3]济南市第二妇幼保健院超声科,山东济南市250000

出　　处：《中国康复理论与实践》2021年第8期936-942,共7页Chinese Journal of Rehabilitation Theory and Practice

摘　　要：目的探讨髋周肌群力量训练对功能性踝关节不稳(FAI)的疗效,并采用表面肌电(sEMG)进行评价。方法从2019年1月至2020年6月,青岛市市立医院FAI患者60例,随机分为对照组(n=30)和观察组(n=30)。对照组患者接受常规治疗,包括踝关节松动训练、力量训练和平衡训练;观察组加用髋周肌群力量训练。治疗前、治疗6周后采用坎伯兰踝关节不稳问卷(CAIT)、星形偏移平衡测试(SEBT)进行评定,采用sEMG测量积分肌电值(iEMG)。臀中肌、臀大肌的iEMG分别与CAIT和SEBT进行Pearson相关性分析。结果试验过程无脱落。治疗前,两组的CAIT评分、SEBT 8个方向距离和iEMG均无显著性差异(P>0.05)。治疗6周后,两组CAIT评分、SEBT 8个方向距离均较治疗前显著增加(t>3.657,P<0.001);观察组的臀中肌和臀大肌iEMG显著增加(t>22.038,P<0.001),对照组无显著变化(t<1.916,P>0.05);观察组CAIT评分、SEBT 8个方向距离及臀中肌、臀大肌iEMG均优于对照组(t>2.125,P<0.05)。观察组臀中肌、臀大肌iEMG均与CAIT、SEBT呈中高度相关(r=0.712~0.866,P<0.05)。结论髋周肌群力量训练可以进一步改善FAI患者踝关节功能。臀中肌、臀大肌的iEMG可以评价力量训练的疗效。Objective To investigate the effect of strength training of hip muscles on functional ankle instability(FAI),and be evaluated with surface electromyography(sEMG).Methods From January,2019 to June,2020,60 FAI patients were recruited in Qingdao Municipal Hospital.They were divided into control group(n=30)and observation group(n=30)randomly.The control group received conventional therapy,including ankle joint mobilization training,strength training and balance training for six weeks,while the observation group received strength training of hip muscles in addition.Cumberland Ankle Instability Tool(CAIT),Star Excursion Balance Test(SEBT)and sEMG were used to assess the function before and after intervention,and integrated electromyography(iEMG)was measured with sEMG.The correlation of CAIT and SEBT to iEMG was analyzed with Pearson coefficient.Results No one dropped out.Before intervention,there was no significant difference between CAIT,SEBT and iEMG between two groups(P>0.05).CAIT and SEBT improved significantly in both groups(t>3.657,P<0.001)af‐ter six-week intervention;the iEMG increased significantly in the observation group(t>22.038,P<0.001),while no significance was found in the control group(t<1.916,P>0.05);all the indexes were better in the ob‐servation group than in the control group(t>2.125,P<0.05).iEMG of gluteus medius and gluteus maximum correlated to CAIT and SEBT in the observation group(r=0.712 to 0.866,P<0.05).Conclusion The strength training of the hip muscles could improve the ankle function of FAI patients.iEMG of gluteus medius and gluteus maximum could be a valid measure to assess the effect of strength training on FAI.

关 键 词：功能性踝关节不稳 髋周肌群 表面肌电 积分肌电值 踝关节 臀中肌 臀大肌 

分 类 号：R684.7[医药卫生—骨科学]