中华物理医学与康复杂志
中華物理醫學與康複雜誌
중화물리의학여강복잡지
CHINESE JOURNAL OF PHYSICAL MEDICINE AND REHABILITATION
2014年
6期
440-444
,共5页
雒晓甜%梁英%李鹏%邓剑伟
雒曉甜%樑英%李鵬%鄧劍偉
락효첨%량영%리붕%산검위
膝骨性关节炎%等速肌力训练%疼痛%关节活动度
膝骨性關節炎%等速肌力訓練%疼痛%關節活動度
슬골성관절염%등속기력훈련%동통%관절활동도
Knee osteoarthritis%Isokinetic strength training%WOMAC index
目的 观察等速肌力训练联合玻璃酸钠关节腔内注射及关节松动术治疗膝骨性关节炎(KOA)的疗效.方法 采用随机数字表法将81例KOA患者分为联合治疗组、常规治疗组及对照组.联合治疗组给予等速肌力训练、玻璃酸钠关节腔内注射及关节松动术治疗,常规治疗组给予玻璃酸钠关节腔内注射及关节松动术治疗,对照组仅遵医嘱进行家庭自我踝泵训练.于治疗前、治疗4周后分别对各组患者膝关节疼痛程度、膝关节活动度、生活质量(采用WOMAC简明健康调查量表评定)及等速肌力指标[包括膝关节屈、伸肌峰力矩值(PT),屈、伸肌峰力矩值对应角度(AOPT)]进行评定.结果 各组患者分别经4周治疗后,发现对照组膝关节疼痛VAS评分、膝关节活动度、WOMAC量表评分(包括疼痛、僵硬、功能评分及总分)、等速肌力指标(包括膝关节屈肌及伸肌PT值、屈肌及伸肌AOPT值)均较治疗前无显著改善(P＞0.05);而联合治疗组及常规治疗组患者上述指标均较治疗前明显改善(P＜0.05),并且联合治疗组患者疼痛VAS评分[(3.34±1.76)分]、膝关节活动度[屈膝(117.66±20.60)°、伸膝(5.69±2.12)°]、WOMAC指数评分[疼痛(110.34 ±49.53)分、僵硬(38.97 ±35.49)分、功能评分(430.52±270.43)分、总分(581.21±322.90)分]及等速肌力指标[膝关节屈肌PT值(21.83±3.63)N·m、伸肌PT值(28.90±6.76)N·m、屈肌AOPT值(99.86±18.94)°、伸肌AOPT值(49.93±6.78)°]亦显著优于常规治疗组及对照组水平(P＜0.05).结论 联合采用等速肌力训练、玻璃酸钠关节腔内注射及关节松动术治疗KOA患者具有协同疗效,能进一步提高患者膝关节稳定性、改善其日常生活活动能力,该联合疗法值得临床推广、应用.
目的 觀察等速肌力訓練聯閤玻璃痠鈉關節腔內註射及關節鬆動術治療膝骨性關節炎(KOA)的療效.方法 採用隨機數字錶法將81例KOA患者分為聯閤治療組、常規治療組及對照組.聯閤治療組給予等速肌力訓練、玻璃痠鈉關節腔內註射及關節鬆動術治療,常規治療組給予玻璃痠鈉關節腔內註射及關節鬆動術治療,對照組僅遵醫囑進行傢庭自我踝泵訓練.于治療前、治療4週後分彆對各組患者膝關節疼痛程度、膝關節活動度、生活質量(採用WOMAC簡明健康調查量錶評定)及等速肌力指標[包括膝關節屈、伸肌峰力矩值(PT),屈、伸肌峰力矩值對應角度(AOPT)]進行評定.結果 各組患者分彆經4週治療後,髮現對照組膝關節疼痛VAS評分、膝關節活動度、WOMAC量錶評分(包括疼痛、僵硬、功能評分及總分)、等速肌力指標(包括膝關節屈肌及伸肌PT值、屈肌及伸肌AOPT值)均較治療前無顯著改善(P＞0.05);而聯閤治療組及常規治療組患者上述指標均較治療前明顯改善(P＜0.05),併且聯閤治療組患者疼痛VAS評分[(3.34±1.76)分]、膝關節活動度[屈膝(117.66±20.60)°、伸膝(5.69±2.12)°]、WOMAC指數評分[疼痛(110.34 ±49.53)分、僵硬(38.97 ±35.49)分、功能評分(430.52±270.43)分、總分(581.21±322.90)分]及等速肌力指標[膝關節屈肌PT值(21.83±3.63)N·m、伸肌PT值(28.90±6.76)N·m、屈肌AOPT值(99.86±18.94)°、伸肌AOPT值(49.93±6.78)°]亦顯著優于常規治療組及對照組水平(P＜0.05).結論 聯閤採用等速肌力訓練、玻璃痠鈉關節腔內註射及關節鬆動術治療KOA患者具有協同療效,能進一步提高患者膝關節穩定性、改善其日常生活活動能力,該聯閤療法值得臨床推廣、應用.
목적 관찰등속기력훈련연합파리산납관절강내주사급관절송동술치료슬골성관절염(KOA)적료효.방법 채용수궤수자표법장81례KOA환자분위연합치료조、상규치료조급대조조.연합치료조급여등속기력훈련、파리산납관절강내주사급관절송동술치료,상규치료조급여파리산납관절강내주사급관절송동술치료,대조조부준의촉진행가정자아과빙훈련.우치료전、치료4주후분별대각조환자슬관절동통정도、슬관절활동도、생활질량(채용WOMAC간명건강조사량표평정)급등속기력지표[포괄슬관절굴、신기봉력구치(PT),굴、신기봉력구치대응각도(AOPT)]진행평정.결과 각조환자분별경4주치료후,발현대조조슬관절동통VAS평분、슬관절활동도、WOMAC량표평분(포괄동통、강경、공능평분급총분)、등속기력지표(포괄슬관절굴기급신기PT치、굴기급신기AOPT치)균교치료전무현저개선(P＞0.05);이연합치료조급상규치료조환자상술지표균교치료전명현개선(P＜0.05),병차연합치료조환자동통VAS평분[(3.34±1.76)분]、슬관절활동도[굴슬(117.66±20.60)°、신슬(5.69±2.12)°]、WOMAC지수평분[동통(110.34 ±49.53)분、강경(38.97 ±35.49)분、공능평분(430.52±270.43)분、총분(581.21±322.90)분]급등속기력지표[슬관절굴기PT치(21.83±3.63)N·m、신기PT치(28.90±6.76)N·m、굴기AOPT치(99.86±18.94)°、신기AOPT치(49.93±6.78)°]역현저우우상규치료조급대조조수평(P＜0.05).결론 연합채용등속기력훈련、파리산납관절강내주사급관절송동술치료KOA환자구유협동료효,능진일보제고환자슬관절은정성、개선기일상생활활동능력,해연합요법치득림상추엄、응용.
Objective To observe any effects of using isokinetic strengthening exercises combined with intra-articular injection of sodium hyaluronate and joint mobilization in treating patients with knee osteoarthritis (KOA).Methods Eighty-one KOA patients were divided into a combined treatment group,a conventional treatment group and a control group.The combined treatment group received isokinetic strengthening training,intra-articular injections of sodium hyaluronate and joint mobilization therapy; the conventional treatment group received the injections and mobilization only; the control group was instructed to do ankle pumps at home on their own.Before the start of treatment and after 4 weeks,knee pain was self-assessed [using a visual analogue scale (VAS) for pain] along with knee range of motion (ROM),quality of life (using the WOMAC condensed health survey rating scale) and indexes of isokinetic strength [including the knee flexors,extensor peak torque (PT),and the flexion and extension angles corresponding peak torque (AOPT)] in both groups.Results After 4 weeks of treatment,statistically significant improvements compared to the baseline values were observed in both groups.The combined treatment group,however,improved to a significantly greater extent than the conventional treatment group in terms of all of the measures.Conclusion Isokinetic strength training combined with intra-articular injections of sodium hyaluronate and joint mobilization has a synergistic effect in enhancing knee stability and improving the performance in activities of daily life of KOA patients.
