肌肉电刺激联合肌力训练对髌股关节痛患者膝关节生物力学特征的影响  

Effects of Muscle Electrical Stimulation Combined with Muscle Strength Training on Biomechanical Characteristics of Knee Joint in Patients with Patellofemoral Pain

作　　者：姚英策 赵建斌 杨晓巍 吴菁 薛博士 王霞[1] 杨辰 郑亮亮[1] 周志鹏[1] YAO Yingce;ZHAO Jianbin;YANG Xiaowei;WU Jing;XUE Boshi;WANG Xia;YANG Chen;ZHENG Liangliang;ZHOU Zhipeng(School of Sports and Health,Shandong Sport Institute,Ji’nan 250102,China;School of Sports and Health,Nanjing Sport Institute,Nanjing 210014,China)

机构地区：[1]山东体育学院运动与健康学院,济南250102 [2]南京体育学院运动健康科学学院,南京210114

出　　处：《医用生物力学》2024年第4期677-684,共8页Journal of Medical Biomechanics

基　　金：山东省高等学校青创人才引育计划项目(2019-183)。

摘　　要：目的探讨6周肌肉电刺激联合肌力训练对髌股关节痛(patellofemoral pain,PFP)患者膝关节生物力学特征的影响。方法招募46名PFP患者,随机分为肌力训练组(muscle strength training,MST)和肌肉电刺激联合肌力训练组(electrical muscle stimulation,EMS),进行为期6周、每周3次的干预。通过膝前痛量表(anterior knee pain scale,AKPS)测试患者膝痛程度,通过红外动作捕捉系统、测力台以及表面肌电测试仪采集受试者干预前后落地起跳动作中膝关节运动学、动力学以及表面肌电数据,采用2×2混合设计方差分析确定两组干预前后各因变量之间的差异。结果与干预前相比,EMS组AKPS评分、股内侧肌激活程度、股内外侧肌肌肉激活比值、膝屈曲最大角度和伸膝力矩峰值在干预后均显著增加,膝最大外展、外旋角度和力矩在干预后显著降低;MST组AKPS评分、膝屈曲最大角度和伸膝力矩峰值在干预后均显著增加,膝最大外展、外旋力矩在干预后显著降低;干预后组间比较发现,EMS组AKPS得分、股内侧肌激活程度和股内外侧肌肌肉激活比值均显著高于MST组,且膝外展最大角度显著低于MST组。结论肌肉电刺激联合肌力训练有助于更好地平衡股内外侧肌肌肉激活,纠正跳跃落地动作时膝关节产生过大的外展角度,进而可能更有助于改善PFP患者的疼痛及下肢功能。Objective To investigate the effects of electrical stimulation combined with muscle strength training on knee joint biomechanical characteristics in patients with patellofemoral pain(PFP).Methods Forty-six patients with PFP were recruited and randomly assigned to the muscle strength training(MST)and electrical muscle stimulation with strength training(EMS)groups.The intervention was performed three times a week for six weeks.The anterior knee pain scale(AKPS)was used to measure the knee pain degree.Knee kinematics,677 dynamics,and surface electromyography(sEMG)data were collected using an infrared motion capture system,force platform,and sEMG system during drop jumps before and after the intervention.Two-way analysis of variance with repeated measures was applied to determine the differences between the dependent variables of the two groups before and after the intervention.Results Compared with pre-intervention,the AKPS score,vastus medialis oblique(VMO)activation,VMO/vastus lateralis(VMO/VL)activation,maximum knee flexion angle,and peak knee extension moment increased significantly in the EMS group;the maximum knee abduction,external rotation angle,and peak knee external rotation moment decreased significantly in the EMS group after intervention.Compared with pre-intervention,the AKPS score,maximum knee flexion angle,and peak knee extension moment increased significantly in the MST group after intervention,the peak knee abduction and external rotation moment significantly decreased in the MST group after intervention.Post-hoc comparisons indicated that compared with the MST group,the AKPS score,VMO activation,VMO/VL activation were significantly higher and the maximum knee abduction angle was significantly lower in the EMS group.Conclusions EMS contributes to the better balance muscle activation of the VMO and VL and corrects the excessive knee abduction angle during jump landing,which may be helpful in relieving pain and improving lower limb function in patients with PFP.

关 键 词：髌股关节痛 运动康复 肌肉电刺激 肌力训练 运动学 动力学 

分 类 号：R318.01[医药卫生—生物医学工程]