开链联合闭链运动训练对前交叉韧带重建术后患者的影响  

Treatment Efficacy of Open Kinetic Chain Combined with Closed Kinetic Chain Exercise Training on Patients after Anterior Cruciate Ligament Reconstruction

作　　者：高鹏 姜鑫[2] 王俊哲 王宏宇 刘承耀 GAO Peng;JIANG Xin;WANG Junzhe;WANG Hongyu;LIU Chengyao(Jinan Zhangqiu District People's Hospital,Jinan,Shandong 250200,China;Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]济南市章丘区人民医院,山东济南250200 [2]上海交通大学医学院附属第九人民医院,上海200011

出　　处：《康复学报》2023年第6期542-548,共7页Rehabilitation Medicine

基　　金：济南市卫生健康委员会科技计划项目(2021-1-48)。

摘　　要：目的:观察开链(OKC)联合闭链(CKC)运动训练对前交叉韧带(ACL)重建术后患者膝关节或下肢运动功能、平衡功能、股四头肌等速肌力和萎缩程度的影响。方法:选择2020年1月—2021年10月在济南市章丘区人民医院行膝关节ACL重建术后患者84例,按照随机数字表法分为OKC组、CKC组、等量联合组和调整联合组,每组21例。OKC组接受OKC训练,CKC组接受CKC训练,等量联合组接受1/2 OKC和1/2 CKC训练,调整联合组接受不同配比OKC和CKC训练,4组均训练12周。分别于干预前后采用Lysholm评分、国际膝关节评分委员会(IKDC)评分评价患侧膝关节功能,测量膝关节韧带KT-1000值,主动和被动关节活动度差值;采用单脚跳、交叉单脚跳测定患侧与健侧跳跃距离比值评价下肢运动功能;采用Fugl-Meyer平衡量表和Berg平衡量表(BBS)评分评估平衡功能;采用等速肌力测试系统分析患侧股四头肌的峰力矩(PT)、平均功率(AP)、总功率(TW)和萎缩指数。结果:①膝关节运动功能:与干预前比较,4组干预后Lysholm评分和IKDC评分均明显升高,KT-1000值、主动关节活动度差值和被动关节活动度差值均明显降低(P<0.05)。与OKC组比较,CKC组干预后Lysholm评分明显更高,CKC组和调整联合组干预后IKDC评分明显更高,KT-1000值、主动关节活动度差值和被动关节活动度差值明显更低(P<0.05);等量联合组干预后主动关节活动度差值明显更低(P<0.05)。②平衡功能:与干预前比较,4组干预后Fugl-Meyer评分和BBS评分均明显更高(P<0.05);4组干预后Fugl-Meyer评分和BBS评分比较,差异均无统计学意义(P>0.05)。③下肢运动功能:与干预前比较,4组干预后患侧与健侧单脚跳及交叉单脚跳跳跃距离比值均明显更高(P<0.05)。与OKC组比较,CKC组和调整联合组干预后患侧与健侧单脚跳及交叉单脚跳跳跃距离比值均明显更高(P<0.05)。④股四头肌等速肌力及萎缩指数:与干预前比较,4组干Objective:To observe the effect of open kinetic chain(OKC)combined with closed kinetic chain(CKC)exercise training on motor function of knee or lower limb,balance function,quadriceps isokinetic muscle strength and atrophy degree after anterior cruciate ligament(ACL)reconstruction.Methods:A total of 84 patients who underwent knee ACL reconstruction in the Jinan Zhangqiu District People's Hospital from January 2020 to October 2021 were randomly divided into OKC group,CKC group,equal combination group and adjusted combination group,with 21 cases in each group.The OKC group received OKC training,the CKC group received CKC training,the equal combination group received equal amount of OKC training and CKC training,and the adjusted combination group received OKC training and CKC training of different proportions.All four groups were trained for 12 weeks.Before and after intervention,Lysholm score and the international knee documentation committee(IKDC)score were used to evaluate the function of the affected knee,the KT-1000 score of the knee ligament and the differences of bilateral active range and passive range of motions;the ratio of jump distance between the affected side and the healthy side during one foot jump and cross foot jump were used to evaluate the lower limb motor function;Fugl-Meyer balance scale and Berg balance scale(BBS)were used to evaluate the balance function;isokinetic muscle strength testing system was used to analyze peak torque(PT),average power(AP),total power(TW)and atrophy index of quadriceps femoris on the affected side.Results:(1)Knee motor function:compared with that before intervention,Lysholm and IKDC scores in four groups after intervention increased significantly,and KT-1000 score,bilateral active and passive joint motion differences decreased significantly(P<0.05).Compared with the OKC group,the Lysholm score in the CKC group after intervention was significantly higher,the IKDC scores were significantly higher in the CKC group and adjusted combination group after intervention,and the

关 键 词：前交叉韧带重建术 开链运动 闭链运动 膝关节运动功能 下肢运动功能 

分 类 号：R687.4[医药卫生—骨科学]