膝关节骨性关节炎患者股四头肌动员能力和肌力储备改变的研究

关键词：肌肉动员能力  肌力储备  膝关节骨性关节炎

Keywords:central activation ratio  activation deficit  knee osteoarthritis

摘要：

      摘要 目的：观察膝关节骨性关节炎（KOA）患者股四头肌肌力，肌肉动员能力及肌力储备并探讨其改变原因，为KOA功能评定和康复治疗提供新的途径和依据。 方法：本次研究对象20例KOA患者为实验组和10例健康人为对照组，利用肌肉随意收缩电刺激叠加法测定股四头肌最大随意收缩力量、肌力储备和动员能力。 结果：KOA组左、右腿股四头肌相对肌力分别为0.22和0.21，两腿没有显著差异（P>0.05）；对照组左腿和右腿相对肌力分别为0.34和0.32，KOA患者相对肌力显著低于对照组（P<0.05）。KOA组左、右腿肌力储备分别为31.09%和29.90%；对照组左、右腿肌力储备分别为18.56%和20.75%，KOA组双侧股四头肌肌力储备显著高于对照组（P<0.01）；KOA组左、右腿动员能力分别为68.95%和70.05%；对照组左、右腿的股四头肌动员能力分别为81.40%和79.20%，KOA组双侧肌肉动员能力显著低于对照组（P<0.05）。 结论：KOA患者存在着股四头肌肌力低下、股四头肌动员能力不足的情况，其肌力下降主要是由于神经肌肉控制能力较差所致，肌肉随意收缩电刺激叠加法可以敏感地反映这一变化。康复治疗可以训练股四头肌神经肌肉控制能力，增加KOA患者股四头肌肌力和关节稳定性。

Abstract:

      Abstract Objective: To investigate the muscle strength, central activation ratio and muscle activation deficit of quadriceps in individuals with knee osteoarthritis（KOA） in order to provide the objective and effective evaluation method and rehabilitation treatment cue for KOA. Method: Twenty subjects with KOA and ten controls with clinically normal knees without any symptom were collected．Maximal voluntary isometric contraction (MVC) and activation of quadriceps were tested by interpolated twitch system. T test was used to analysis the data. Result: Relative quadriceps strength of left leg and right leg in KOA group was 0.22 and 0.21 respectively. The relative quadriceps strength of both legs in control group was 0.34 and 0.32, respectively. Compared with those in control group, there was significant lower level of relative quadriceps strength in KOA group(P<0.05). The muscle activation deficit of quadriceps in KOA group was 31.09% and 29.90% respectively,while those in control group were 18.56% and 20.75% respectively. Compared with those in control group, there were significant higher level of muscle activation deficit in KOA group(P<0.01). The central activation ratio of quadriceps in KOA group were 68.95% and 70.05% respectively, while those in control group were 81.40% and 79.20% respectively. Significant reduction of central activation ratio in KOA group was found compared to those in control group(P<0.05). Conclusion: Patients with KOA had quadriceps weakness, deficient quadriceps neuroactivation which may prompt to develop a goal-oriented neural motor control rehabilitation program for KOA. The interpolated twitch system for assessing quadriceps activation is sensitive and reliable，and can be applied in the neuromuscular function evaluation clinically, including the quadriceps of KOA．