膝骨关节炎患者股四头肌功能水平及髋关节步态运动学特征分析  

Function of quadriceps femoris and kinematic characteristics of hip gait in patients with knee osteoarthritis

作　　者：马淑敏 高谦 徐峰[2] 谢娜 林瑞珠[3] Ma Shumin;Gao Qian;Xu Feng(Ningxia Medical University,Ningxia 750000,China)

机构地区：[1]宁夏医科大学,宁夏750000 [2]北京大学国际医院,北京102206 [3]宁夏医科大学总院,宁夏750000

出　　处：《中国康复》2023年第6期345-349,共5页Chinese Journal of Rehabilitation

基　　金：吴阶平医学基金会(320.6750.19089-76)。

摘　　要：目的:观察中老年膝骨关节炎(KOA)患者股四头肌功能水平及步行过程中髋关节的运动学特征。方法:选取18例KOA患者为KOA组,8例无KOA者为对照组,2组的年龄、身高、体重和身体质量指数(BMI值)相匹配。2组受试者均进行等速肌力测试、无线表面肌电测试及步态测试,测试及比较2组股四头肌峰力矩(PT值)、股内侧肌(VM)、股外侧肌(VL)和股直肌(RF)的积分肌电值(iEMG)、均方根值(RMS)、平均功率频率(MPF)及峰值髋内收、外展角度等和步行中髋关节的运动学特征,将股四头肌肌力与髋关节运动学特征进行相关性分析。结果:KOA组股四头肌等长和等速运动时PT值较对照组显著下降(P<0.01),VL在60°/s等速收缩时表面肌电信号RMS值显著高于对照组(P<0.05),RF在180°/s等速收缩时表面肌电信号RMS值显著高于对照组(P<0.01),步行时峰值髋关节内收及外展角度显著低于对照组(P<0.05),股四头肌肌力与髋关节运动学特征无相关。结论:KOA组较对照组股四头肌肌力显著降低,活动时神经支配效率显著下降,且步行过程中峰值髋内收、外展角度显著减少,股四头肌肌力与步行中髋关节运动学特征无关。Objective:To observe the characteristics of quadriceps muscle strength,nerve domination and hip joint movement during walking in elderly patients with knee osteoarthritis(KOA).Methods:A total of 18 KOA patients were selected as the observation group,and 8 patients without KOA were selected as the control group.The age,height,weight and body mass index(BMI)of the two groups were matched.The isokinetic muscle strength test,wireless surface electromyography test and gait test were performed in both groups.The integral electromyography(iEMG),mean square root(RMS),average power frequency(MPF)and peak torque(PT),medial vastus muscle(VM),lateral femoral muscle(VL)and rectus femoris(RF)and peak hip inward and outward angles were selected to analyze the correlation between quadriceps femoris function and kinematic characteristics of hip joint during walking by independent sample t test or Mann Whitney rank sum test.Results:The PT value of quadriceps femoris in KOA patients was significantly lower than that in the control group at isometric and isokinetic exercise(P<0.01).The RMS value of surface electromyography in VL at 60°/s isometric contraction was significantly higher than that in the control group(P<0.05).The RMS value of surface EMG in RF at 180°/s isometric contraction was significantly higher than that in the control group(P<0.01).The peak hip adduction and abduction angles during walking were significantly lower than those in the control group(P<0.05).There was no correlation between quadriceps muscle strength and hip kinematics.Conclusion:The muscle strength of quadriceps femoris in KOA group was significantly lower than that in the control group,and the innervation efficiency during activity was significantly decreased,and the peak hip adduction and abduction angles during walking were significantly reduced.The quadriceps muscle strength is not correlated to the kinematic of the hip joint during walking.

关 键 词：膝骨关节炎 等速肌力 表面肌电 步态 

分 类 号：R49[医药卫生—康复医学] R684[医药卫生—临床医学]