等速向心和离心肌力训练对前交叉韧带重建术后膝关节屈伸肌群肌力影响的对比研究  

A comparative study of the effects of centripetal versus centrifugal isokinetic muscle strength training on knee flexor/extensor muscle strength after anterior cruciate ligament reconstruction

作　　者：蒋拥军 李克军 邵开超 黄若彬 何梦凡 汪伟 JIANG Yongjun;LI Kejun;SHAO Kaichao;HUANG Ruobin;HE Mengfan;WANG Wei(Shenzhen Pingle Orthopedic Hospital(Shenzhen Pingshan District Hospital of Traditional Chinese medicine),Shenzhen 518010,Guangdong,China)

机构地区：[1]深圳平乐骨伤科医院/深圳市坪山区中医院,广东深圳518010

出　　处：《中医正骨》2022年第7期27-33,共7页The Journal of Traditional Chinese Orthopedics and Traumatology

基　　金：深圳市坪山区卫生系统科研项目(201845)。

摘　　要：目的:比较等速向心和离心肌力训练对前交叉韧带(anterior cruciate ligament,ACL)重建术后膝关节屈伸肌群肌力的影响。方法:选择80例近期因ACL断裂接受过ACL重建术,且术后接受过3个月相同的常规康复训练的患者,随机分为2组,每组40例。采用TURISOFORCE等速肌力评估训练系统进行等速肌力训练,向心训练组进行等速向心肌力训练,离心训练组进行等速离心肌力训练;2组患者均隔日训练1次,每周训练3次,共训练8周。详细记录试验过程中出现的不良事件,采用TUR ISOFORCE等速肌力评估训练系统测定患者的膝关节屈伸肌群峰力矩(peaktorque,PT),并利用系统自动计算膝关节屈伸肌群峰力矩与体质量比值(peak torque/body weight,PT/BW)和膝关节屈伸肌群峰力矩比值(flexor/extensor,F/E)。结果:①膝关节屈伸肌群PT。2组男性患者治疗前和治疗结束后的膝关节伸肌群PT比较,组间差异均无统计学意义[(85.45±10.45)N·m,(88.12±9.96)N·m,t=0.866,P=0.392;(118.37±12.45)N·m,(123.78±13.39)N·m,t=1.389,P=0.172];治疗结束后2组男性患者的膝关节伸肌群PT均较治疗前增大(t=13.496,P=0.000;t=12.207,P=0.000)。2组男性患者治疗前和治疗结束后的膝关节屈肌群PT比较,组间差异均无统计学意义[(48.93±8.47)N·m,(50.23±9.17)N·m,t=0.489,P=0.628;(78.56±10.25)N·m,(83.69±11.36)N·m,t=1.575,P=0.123];治疗结束后2组男性患者的膝关节屈肌群PT均较治疗前增大(t=11.616,P=0.000;t=14.325,P=0.000)。2组女性患者治疗前和治疗结束后的膝关节伸肌群PT比较,组间差异均无统计学意义[(48.16±7.43)N·m,(46.72±8.16)N·m,t=0.551,P=0.585;(65.38±9.96)N·m,(66.07±10.33)N·m,t=0.204,P=0.840];治疗结束后2组女性患者的膝关节伸肌群PT均较治疗前增大(t=17.556,P=0.000;t=10.907,P=0.000)。2组女性患者治疗前和治疗结束后的膝关节屈肌群PT比较,组间差异均无统计学意义[(26.93±5.47)N·m,(25.26±6.17)N·m,t=0.855,P=0.399;(41.84±6.25)N·m,Objective:To compare the effects of centripetal versus centrifugal isokinetic muscle strength training on knee flexor/extensor muscle strength after anterior cruciate ligament(ACL)reconstruction(ACLR).Methods:Eighty patients who underwent ACLR for ACL rupture and received the same conventional rehabilitation training for 3 months after the surgery were selected and randomly divided into centripetal training group and centrifugal training group, 40 cases in each group.The knee isokinetic muscle strength training was conducted via TUR ISOFORCE isokinetic muscle strength assessment training system.The patients in centripetal training group were instructed to perform isokinetic centripetal strength training, while the ones in centrifugal training group were instructed to perform isokinetic centrifugal strength training.All patients in the 2 groups were trained 1 time every other day, 3 times a week for consecutive 8 weeks.The adverse events occurred during the test were recorded in detail.The peak torque(PT)of knee flexor/extensor muscles was measured by using the TUR ISOFORCE isokinetic muscle strength assessment training system, meanwhile, the ratios of knee flexor/extensor muscle PT to body weight(PT/BW)and knee flexor muscle PT to knee extensor muscle PT(F/E)were calculated and recorded automatically by the TUR ISOFORCE isokinetic muscle strength assessment training system.Results:(1)There was no statistical difference in PTs of knee extensor muscles of the male patients between the 2 groups before the treatment and after the end of the treatment(85.45±10.45 vs 88.12±9.96 N/m, t=0.866,P=0.392;118.37±12.45 vs 123.78±13.39 N/m, t=1.389,P=0.172).The PTs of knee extensor muscles of the male patients increased after the end of the treatment compared to pretreatment in the 2 groups(t=13.496,P=0.000;t=12.207,P=0.000).There was no statistical difference in PTs of knee flexor muscles of the male patients between the 2 groups before the treatment and after the end of the treatment(48.93±8.47 vs 50.23±9.17 N/m, t=0.48

关 键 词：前交叉韧带重建术 肌力训练 等速肌力评定 向心收缩 离心收缩 临床试验 

分 类 号：R687.4[医药卫生—骨科学]