运动疗法对早期膝骨关节炎患者下肢生物力学风险因素的影响研究  

A Study on the Impact of Exercise Therapy on Lower Limb Biomechanical Risk Factors in Patients with Early Knee Osteoarthritis

作　　者：陈博 苏婵娟[1] 王乃针[1] CHEN Bo;SU Chan-juan;WANG Nai-zhen

机构地区：[1]福州市第二医院,福建福州350001

出　　处：《风湿病与关节炎》2024年第6期11-15,20,共6页Rheumatism and Arthritis

基　　金：福建省创伤骨科急救与康复临床医院研究中心项目(2020Y2014);福州市卫生健康中青年科学研究项目(2021-S-wq10,2021-S-wq3)。

摘　　要：目的:采用无线表面肌电分析技术探究运动疗法对早期膝骨关节炎患者干预前后的生物力学风险因素的影响。方法:选取2022年2月至2023年6月在福州市第二医院骨科和康复科门诊就诊的早期膝骨关节炎患者98例,随机分为观察组和对照组,每组49例。观察组采用等速肌力训练和平衡本体感觉训练,每周3次,持续4周;对照组采用健康宣教的方式,每周1次,持续4周。观察2组治疗前后股内外侧肌激活比值(VM/VL)、股外侧肌和腘绳肌的激活比值(VL/BF)、前后轴距和左右轴距、西安大略大学和麦克马斯特大学骨关节炎指数(WOMAC)评分、视觉模拟评分法(VAS)评分。结果:治疗后,观察组VM/VL提高,VL/BF降低,前后轴距和左右轴距降低,WOMAC评分、VAS评分显著下降,差异均有统计学意义(P < 0.05)。对照组治疗前后VM/VL、VL/BF、前后轴距和左右轴距、WOMAC评分、VAS评分比较,差异均无统计学意义(P > 0.05)。治疗后,观察组以上指标均优于对照组,差异有统计学意义(P < 0.05)。结论:运动疗法可提升早期膝骨关节炎膝周内外侧和前后侧肌群协同收缩能力,提升患者下肢平衡和本体感觉能力,改善患者疼痛与僵硬的症状,对早期膝骨关节炎患者疾病生物力学风险因素具有调控作用,可延缓疾病进展,提高患者膝关节功能。Objective:To explore the effects of exercise therapy on biomechanical risk factors in patients with early knee osteoarthritis before and after intervention using wireless surface electromyography analysis technology.Methods:Ninty-eight patients with early knee osteoarthritis were selected,who visited the orthopedics and rehabilitation clinics of Fuzhou Second Hospital from February 2022 to June 2023.The patients were randomly divided into an observation group and a control group,with 49 cases in each group.The observation group received isokinetic muscle strength training and balance proprioception training,three times a week for four weeks;The control group received health education,once a week,for a duration of four weeks.Observe the activation ratio(VM/VL)of the medial and lateral femoris muscles,the activation ratio(VL/BF)of the lateral femoris and hamstring muscles,the anteroposterior and left and right wheelbases,the osteoarthritis index(WOMAC)scores of the University of Western Ontario and McMaster University,and the visual analogue scale(VAS)scores before and after treatment in two groups.Result:After treatment,the observation group showed an increase in VM/VL,a decrease in VL/BF,a decrease in front and rear wheelbase,left and right wheelbase,and a significant decrease in WOMAC and VAS scores,with statistical significance(P<0.05).There was no statistically significant difference in VM/VL,VL/BF,front and rear wheelbase,left and right wheelbase,WOMAC score,and VAS score between the control group before and after treatment(P>0.05).After treatment,the above indicators in the observation group were better than those in the control group,and the difference was statistically significant(P<0.05).Conclusion:Exercise therapy can enhance the ability of the inner,outer,anterior and posterior muscle groups to synergistically contract in early knee osteoarthritis,enhance lower limb balance and proprioceptive ability,improve symptoms of pain and stiffness,regulate the biomechanical risk factors of early knee osteoarthri

关 键 词：早期膝骨关节炎 运动疗法 生物力学 风险因素 临床研究 

分 类 号：R684.3[医药卫生—骨科学]