活动终末端等长收缩训练对膝关节骨折术后活动范围的影响

关键词：等长收缩  膝关节  功能障碍  关节活动范围

Keywords:isometric exercises  knee joint  dysfunction  range of motion

摘要：

      目的：探讨在关节活动终末端进行等长收缩训练对骨折手术后3个月以上病程的患者膝关节活动范围的影响。方法：选择膝关节周围骨折手术后固定时间超过3个月，且出现明显膝关节活动功能障碍的患者28例，并随机分成治疗组和对照组。两组患者均先进行理疗（蜡疗或热敷治疗）、关节松动术等治疗，以及屈伸膝的等张收缩训练，5次/周，治疗组另于等张收缩训练后进行膝关节屈、伸活动终末端等长收缩训练，但两组患者每天总主动肌力训练时间相等。两组患者均于锻炼90d后测量角度值行统计学分析。结果：两组患者在治疗前屈、伸膝的主、被动运动角度均无明显差异（P>0.05）。经过治疗和功能锻炼后，两组患者主被动屈伸膝关节角度均有显著改善（P<0.01），治疗组主动屈曲角度较对照组改善显著（P<0.05），被动屈、伸膝角度和主动伸膝角度两组间比较均无明显差异（P>0.05）。结论：关节活动终末端等长收缩训练对损伤术后膝关节固定时间较长，且出现严重关节活动功能障碍的患者的功能改善有积极的意义。

Abstract:

      Objective:To study the effectiveness of isometric exercises on knee joint active termination of the patients three months after surgery. Method:Twenty-eight patients who were three months after surgery with limitation of knee joint motion participated in this study, and they were randomized by a treated group and a control group. All of patients in two groups received physiotherapy (heat therapy), joint mobilization and isotonic training of knee flexion and extension. Meanwhile, patients in treated group received isometric exercise near the maximum angle of knee flexion and extension after isotonic training. The total time of active muscle power training daily in two groups were equal. After 90 days training, we got the angle of knee movement and statisticals analysed. Result:No difference was found between the angles of active and passive knee joint flexion and extension in the two groups before therapy（P>0.05）. Both the active and passive motion angle of knee flexion and extension in the two groups had been improved significantly（P<0.001）. The maximum angle of active flexion of knee joint in the treated group had been improved more significantly than that in control group（P<0.05）. No significant difference was found between the passive knee flexion angle of the two groups, and between the active knee extension angle, either（P>0.05）. Conclusion:The isometric exercise near the maximum knee flexion angle is effective on functional improvement of patients who has knee joint limitation after long-term′s joint immobilization.