标题：膝关节主动等速向心结合离心肌力训练对膝部骨性关节炎患者肌肉力量及膝关节性能的影响

      作者：张修库 1，王党军 2    1.千阳县人民医院骨科，陕西 千阳 712200；2.延川县人民医院骨外科，陕西 延川 717200

      卷次： 2019年30卷6期

      【摘要】 目的 探讨膝关节主动等速向心结合离心肌力训练对膝部骨性关节炎患者肌肉力量及膝关节性能的影响。方法 选取2013年3月至2018年3月在千阳县人民医院住院治疗的120例膝部骨性关节炎患者为研究对象，采用随机数表法分为对照组和观察组，每组60例，观察组采取主动等速向心结合离心肌力训练法治疗，对照组采取等长结合等张肌力训练法治疗，共治疗8周，记录两组患者训练前后最大单次动作量、力矩加速能量、平均功率、患膝峰力矩、训练开始前后疗效、临床症状总积分、膝关节疼痛程度积分、膝关节日常活动能力积分和膝关节活动度积分及患者不良反应状况。结果 观察组患者的治疗总有效率为96.67%，略高于对照组的83.33%，但差异无统计学意义(P>0.05)；观察组患者的治疗显愈率为63.33%，明显高于对照组的30.00%，差异有统计学意义(P<0.05)；治疗后，两组患者的疼痛积分、膝关节日常活动能力积分和膝关节活动度积分均显著下降，且观察组以上三类积分均低于对照组，差异均有统计学意义(P<0.05)；观察组患者治疗前后临床症状总积分分别为(23.97±2.26)分、(10.14±1.65)分，对照组患者分别为(23.88±2.22)分、(14.04±1.94)分，治疗后，两组患者临床症状总积分均显著下降，且观察组临床症状总积分低于对照组，差异均有统计学意义(P<0.05)；两组患者治疗过程中均无不良反应发生。结论 膝关节主动等速向心结合离心肌力训练能够降低膝部骨性关节炎患者疼痛，增强患者日常活动能力和膝关节活动程度，疗效显著。
      【关键词】 膝关节；主动等速；向心；离心；肌力训练；膝部骨性关节炎；疗效
      【中图分类号】 R684.3 【文献标识码】 A 【文章编号】 1003—6350（2019）06—0731—05

Effect of active isokinetic centripetal knee joint combined with centrifugal muscle strength training on musclestrength and knee joint performance in patients with knee osteoarthritis.
ZHANG Xiu-ku 1, WANG Dang-jun 2.1. Department of Orthopaedics, Qianyang County People's Hospital, Qianyang 712200, Shaanxi, CHINA; 2. Department ofBone Surgery, Yanchuan County People's Hospital, Yanchuan 717200, Shaanxi, CHINA
【Abstract】 Objective To investigate the effect of active isokinetic centripetal training combined with centrif-ugal muscle strength training on muscle strength and knee joint performance in patients with knee osteoarthritis.Methods A total of 120 patients with knee osteoarthritis, who admitted to Qianyang County People's Hospital fromMarch 2013 to March 2018, were selected and divided into the control group and the observation group according to ran-dom number table method, with 60 cases in each group. The observation group was treated with active isokinetic centrip-etal force combined with myocardial force training, and the control group was treated with isometric strength combinedwith isotonic muscle training for a total of eight weeks. The maximum single action volume, torque acceleration energyaverage power, knee peak torque, pre- and post-training efficacy, total clinical symptom scores, knee joint painscores, knee joint activity scores and knee joint activity scores and patients’adverse reactions before and after train-ing were recorded. Results The total effective rate of the observation group was 96.67%, which was slightly higherthan 83.33% of the control group, but the difference was not statistically significant (P>0.05); the treatment cure rate ofthe observation group was 63.33% , which was significantly higher than 30.00% of the control group (P<0.05). Aftertreatment, the pain scores, knee activity index, and knee activity scores of the two groups were significantly decreased,and the above three types of points in the observation group were significantly lower than those in the control group (P<0.05). The total scores of clinical symptoms before and after treatment in the observation group were 23.97±2.26 and10.14 ± 1.65, respectively, and those in the control group were 23.88 ± 2.22 and 14.04 ± 1.94. After treatment, the totalscores of clinical symptoms of the two groups were significantly decreased, and the total score of clinical symptoms inthe observation group was significantly lower than the control group (P<0.05); no adverse reactions occurred during thetreatment of the patients. Conclusion Active isokinetic centripetal knee joint training combined with centrifugal mus-cle strength training can reduce the pain of knee osteoarthritis patients, enhance the daily activity ability, and knee jointactivity degree of patients, which has the remarkable effect.
      【Key words】 Knee joint; Active isokinetic; Centripetal; Centrifugal; Muscle strength training; Knee osteoarthri-tis; Therapeutic effect