股四头肌肌力和步行能力在废用性膝关节挛缩患者运动功能与日常活动能力的链式中介效应  

Chain Mediating Effects of Quadriceps Muscle Strength and Walking Ability on Motor Function and Daily Activity in Patients with Disuse Knee Contracture

作　　者：王宁宁 李晶晶 苗田雨 努尔比亚·克其克 夏热帕·阿不都拉 阿斯古丽·图尔荪 帕丽达·买买提[1] Wang Ningning;Li Jingjing;Miao Tianyu;Nuerbiya·Keqike;Xiarepa·Abudoua;Asigui·Tuersun;Paida·Maimaiti(School of Nursing,Xinjiang Medical University,Urumqi 830011;The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830011)

机构地区：[1]新疆医科大学护理学院,乌鲁木齐830011 [2]新疆医科大学第一附属医院,乌鲁木齐830011

出　　处：《国际老年医学杂志》2023年第4期475-480,共6页International Journal of Geriatrics

基　　金：国家自然科学基金项目(82060417)。

摘　　要：目的探究股四头肌肌力和步行能力对废用性膝关节挛缩患者运动功能与日常活动能力的链式中介作用。方法选取2022年2~8月新疆医科大学第一附属医院康复科126例废用性膝关节挛缩患者为研究对象,采用调查问卷、MMT分级法评定、Fugl-Meyer运动功能评定、Barthel指数和Holden功能性步行量表进行评定。用电子病历及问卷调查方式进行资料收集,回收有效问卷126份进行统计学分析。结果废用性膝关节挛缩患者的股四头肌肌力总分为3(1,4)分,步行能力总分为1(0,4)分,运动功能总分为14(9,24)分,日常生活活动能力总分为52.5(25,80)分。废用性膝关节挛缩患者的股四头肌肌力总分与步行能力总分、运动功能总分及日常活动能力总分均呈正相关(P<0.001)。以运动功能、股四头肌肌力及步行能力为预测变量,日常活动能力为结果变量,废用性膝关节挛缩患者的运动功能、股四头肌肌力及步行能力能显著正向预测日常活动能力(β=1.497、3.650、5.869,P<0.01)。运动功能对日常活动能力的间接效应成立,总间接效应为1.147,其中股四头肌肌力和步行能力的特定中介效应分别占31.30%和37.40%,两者的链式中介作用占31.39%。结论废用性膝关节挛缩患者的日常生活活动能力处于中等偏上水平,股四头肌肌力和步行能力在废用性膝关节挛缩患者运动功能与日常活动能力间发挥链式中介作用。Objective To explore the interrelationships between quadriceps muscle strength,walking ability,motor function,and daily activity in patients with disuse knee contracture.Methods A study was conducted at the Rehabilitation Department of the First Affiliated Hospital of Xinjiang Medical University between February 2022 and August 2022.A total of 126 patients were enrolled and assessed using a questionnaire survey,manual muscle testing(MMT)grading,Fugl-Meyer motor function assessment,Barthel index,and Holden Functional Walking scale.Results The findings revealed that the patients with disuse knee contracture exhibited scores indicating limited quadriceps muscle strength,impaired walking ability,compromised motor function,and reduced ability to perform daily activities.Specifically,the average scores were 3(1,4)for quadriceps muscle strength,1(0,4)for walking ability,14(9,24)for motor function,and 52.5(25,80)for activities of daily living.Significant positive correlations were observed between the total quadriceps muscle strength score and the scores for walking ability,motor function,and daily activity ability(P<0.001).Moreover,a predictive model utilizing motor function,quadriceps muscle strength,and walking ability as independent variables and daily activity ability as the outcome variable demonstrated significant positive associations between motor function,quadriceps muscle strength,walking ability,and daily activity ability(β=1.497,3.650,5.869,P<0.01).These results suggest that motor function,quadriceps muscle strength,and walking ability positively contribute to daily activity ability.Further analysis revealed a mediating effect of motor function on daily activity ability,with an overall indirect effect size of 1.147.Specifically,the specific mediating effects of quadriceps muscle strength and walking ability accounted for 31.30% and 37.40% of the total indirect effect,respectively,while the mediating chain effect accounted for 31.39%.Conclusion Patients with disuse knee contracture demonstrated moderate to i

关 键 词：废用综合征 膝关节挛缩 股四头肌肌力 步行能力 运动功能 日常生活活动能力 

分 类 号：R473.6[医药卫生—护理学]