等速肌力训练对早中期膝关节骨性关节炎患者膝关节功能的影响

目的 探讨等速肌力训练对早中期膝关节骨性关节炎患者膝关节功能的影响。方法 选取2016年6月~2018年1月天津北大医疗海洋石油医院康复医学科收治的早中期KOA患者90例为研究对象,随机分为观察组及对照组,每组45例。对照组在常规药物治疗基础上给予关节松动训练和威伐光治疗,观察组在对照组治疗基础上增加等速肌力训练。评估所有患者治疗前、治疗后4周视觉模拟评分（VAS）、膝关节主动活动度（AROM）、Lysholm膝关节功能评分,并进行等速肌力测试。结果 与治疗前相比,经4周治疗后所有患者VAS评分、AROM评分、Lysholm膝关节功能评分,峰力矩（PT）、总功量（Tw）均较治疗前有改善,观察组治疗后VAS评分（2.65±0.81）分、AROM评分（92.23±7.83）分、Lysholm膝关节功能评分（76.23±5.42）分、伸肌群PT（67.23±5.42）N·m、屈肌群PT（51.35±4.72）N·m、伸肌群Tw（638.43±202.31）N·m、屈肌群Tw（616.50±210.52）N·m改善均优于对照组的（3.82±0.65）分、（81.98±7.38）分、（67.90±4.22）分、（56.90±4.32）N·m、（41.17±5.13）N·m、（520.32±211.51）N·m、（495.01±197.43）N·m,差异有统计学意义（P＜0.05）。结论 在关节松动训练和威伐光治疗治疗基础上增加等速肌力训练,可更好改善早中期KOA患者关节活动度、疼痛、肌力,进而改善患者膝关节功能及日常生活能力。     

关节镜下半月板切除术与半月板成形术治疗膝关节半月板损伤的效果及对膝关节功能的影响

目的:探究关节镜下半月板切除术与半月板成形术治疗膝关节半月板损伤的效果及对膝关节功能的影响。方法:回顾性分析本院2017年7月至2019年12月收治的90例膝关节半月板损伤患者的临床资料,按照手术方式分为研究组(n=41)与对照组(n=49),两组患者均采用关节镜进行诊治,其中研究组患者所用术式为半月板成形术,而对照组患者所用术式为半月板切除术。治疗6 m后,采用Lysholm评分比较患者的膝关节功能,采用疼痛视觉模拟评分(Visual analog scale,VAS)评分比较患者疼痛程度,采用Ikeuchi评分比较患者疗效,并记录术后6个月内并发症的发生情况。结果:治疗6个月后,研究组总有效率及Lysholm评分明显高于对照组(P<0.05),而VAS评分与对照组无明显差异(P>0.05);治疗后6个月内研究组并发症发生率明显低于对照组(P<0.05)。结论:相较关节镜下半月板切除术,关节镜下半月板成形术更适合治疗膝关节半月板损伤,可以改善患者膝关节功能,且并发症的发病率低。     

关节镜联合PRP治疗对膝关节半月板损伤患者临床疗效、疼痛及关节功能的影响研究

目的分析关节镜联合自体富血小板血浆(PRP)治疗对膝关节半月板损伤患者临床疗效、疼痛及关节功能的影响。方法收集本院2017年2月至2019年5月收治的96例膝关节半月板损伤患者的临床资料,根据治疗方法不同分为对照组(关节镜手术治疗)和观察组(关节镜联合PRP治疗),每组各48例。对比两组患者治疗后临床效果、疼痛情况以及关节功能。结果观察组患者的治疗总有效率为97.91%,明显高于对照组的70.83%(P0.05);治疗后观察组患者VAS评分明显低于对照组,Lysholm评分明显高于对照组(P0.05)。结论关节镜联合PRP治疗膝关节半月板损伤患者效果好,可更有效缓解患者膝关节疼痛症状,改善膝关节功能。     

关节镜下半月板成形术治疗盘状半月板损伤的效果研究

目的:探讨关节镜下半月板成形术对盘状半月板损伤患者的疗效.方法:选取2018年10月至2020年1月我院收治的盘状半月板损伤患者91例,按治疗方案不同分为成形组(n=46)和全切组(n=45).全切组患者予以关节镜下半月板全切术,成形组患者予以关节镜下半月板成形术.手术结束时统计两组患者手术时间、术中出血量,出院时统计两组患者住院时间、并发症发生率,术后3 m评估两组患者手术效果;术前、术后3 m采用美国纽约特种外科医院膝关节评分(Hostipal for special surgery,HSS)评估两组患者膝关节功能,包括节稳定性、屈曲畸形、肌力、活动度、行走功能、疼痛;采用酶联免疫法测定关节液基质金属蛋白酶1(Matrix metalloproteinase-1,MMP-1)、胰岛素样生长因子I(Insulin-like growth factor I,IGF-I)、骨钙素(Osteocalcin,BGP)水平.结果:成形组患者住院时间以及并发症发生率明显短于全切组(P<0.05);术后3 m成形组手术总有效率明显高于全切组(P<0.05);与治疗前对比,术后3 m各治疗组行走功能、活动度、屈曲畸形、稳定性评分均显著升高,MMP-1、IGF-1、BGP水平显著降低(P<0.05),其中成形组更为显著(P<0.05).结论:关节镜下半月板成形术治疗盘状半月板损伤效果显著,能有效缩短住院时间,保护关节软骨,改善膝关节功能,且安全性高.     

自体脂肪来源血管基质组分治疗膝关节骨关节炎的临床研究

目的 探讨自体脂肪来源血管基质组分(SVF)治疗膝关节骨关节炎的疗效。方法 选取于北部战区总医院诊治的膝关节骨关节炎患者48例,按照随机数字表法分为观察组(自体脂肪来源SVF关节腔内注射)和对照组(玻璃酸钠关节腔内注射)。比较2组患者术前及术后3、6、12、18个月膝关节WOMAC评分、Lysholm评分、视觉模拟量表(VAS)评分及注射后相关不良反应的发生情况。记录2组患者末次随访时半月板及软骨损伤信号改善情况。结果 48例患者中有45例完成随访,平均随访(19.2±0.9)个月。2组患者术前及术后3个月WOMAC评分、Lysholm评分比较差异无统计学意义(P>0.05);术后6、12、18个月观察组的WOMAC评分、Lysholm评分优于对照组,差异有统计学意义(P<0.05)。2组患者术前及术后3、6、12个月VAS评分比较差异无统计学意义(P>0.05);术后18个月观察组VAS评分低于对照组,差异有统计学意义(P<0.05)。2组患者不良反应发生率比较差异无统计学意义(P>0.05)。观察组末次随访时观察到半月板及软骨损伤信号较治疗前改善,而对...     

胫骨高位截骨钢板置入联合关节镜治疗伴下肢力线不良的内侧半月板后角退变性损伤北大核心

背景:既往研究发现,胫骨高位截骨和胫骨高位截骨联合关节镜手术均能够有效治疗合并下肢力线不良的内侧间室骨关节炎,但对比二者治疗效果的研究较少。目的:对比胫骨高位截骨与胫骨高位截骨后钢板置入联合关节镜手术治疗伴下肢力线不良的内侧半月板后角退变性损伤的临床疗效。方法:选择2015年7月至2019年1月遵义医科大学附属医院收治的膝关节骨关节炎患者48例,均伴下肢力线不良的内侧半月板退变性损伤,其中24例接受胫骨高位截骨钢板置入联合关节镜手术(试验组),另24例接受单纯的胫骨高位截骨钢板置入手术(对照组)。比较两组患者术后不同时间点的膝关节功能评分及影像学检测指标。结果与结论:(1)试验组患者术后6,12个月的纽约特种外科医院膝关节评分、膝关节Lysholm评分均高于对照组(P <0.05),两组术后24,36个月的纽约特种外科医院膝关节评分、膝关节Lysholm评分比较差异无显著性意义(P> 0.05);试验组患者术后6个月的目测类比评分低于对照组(P <0.05),两组术后12,24,36个月的目测类比评分比较差异无显著性意义(P> 0.05);(2)术后12个月的影像学检查显示,两组患者的下肢力线与股胫角均得到有效改善,两组间股胫角、下肢力线通过胫骨平台的相对位置、胫骨平台后倾角比较差异均无显著性意义(P>0.05);(3)结果表明,胫骨高位截骨钢板置入及联合关节镜手术均能有效治疗伴下肢力线不良的内侧半月板后角退变性损伤,有效改善患者关节功能、缓解疼痛症状,其中胫骨高位截骨联合关节镜手术治疗的早期临床疗效更好。     

关节腔内注射生物制剂修复膝关节骨性关节炎:对关节软骨及功能的影响

背景:采用透明质酸或复方倍他米松治疗膝关节骨性关节炎,均能减轻关节内的炎性反应,缓解疼痛,保护膝关节功能。目的:观察透明质酸与复方倍他米松联合关节腔内注射治疗中期膝关节骨性关节炎的临床疗效及对关节功能的保护效果。方法:纳入Ⅱ、Ⅲ期膝关节骨性关节炎患者100例,采用随机数字表法均分为2组治疗,对照组膝关节腔内注射透明质酸溶液2 m L,试验组膝关节腔内注射透明质酸2 mL+复方倍他米松1 m L的混合液,1次/周,连续5周完成治疗。对比治疗前后的膝关节目测类比评分、Lysholm膝关节评分及静脉血沉指标。结果与结论:两组治疗后1,3,6个月的膝关节目测类比评分、Lysholm膝关节评分及静脉血沉均较治疗前明显改善(P0.05)。试验组治疗后1,3,6个月的膝关节目测类比评分、Lysholm膝关节评分及静脉血沉均优于对照组(P0.05),两组均未发生严重的全身不良反应。表明针对中期膝关节骨性关节炎患者,透明质酸与复方倍他米松联合关节腔内注射可降低炎性反应,减轻疼痛,营养关节软骨,提高关节功能。     

不同频率肌力训练对膝关节镜下半月板成形术后患者功能康复的影响

目的 探讨膝关节镜下半月板成形术后不同频率肌力训练对患者功能康复及生活质量的影响。方法 选择2016年1月~2019年1月我院收治的行膝关节镜下半月板成形术患者84例为研究对象,采用随机数字表分为对照组和观察组,每组42例。对照组肌力训练次数控制在100次以内,观察组肌力训练次数在300次以上,比较两组治疗30 d后的康复程度、治疗前后生活质量（QOL）评分、治疗前与治疗10、20、30 d后膝关节功能评分（Lysholm评分）。结果 治疗后观察组拄拐、肿胀以及跋行情况低于对照组,差异有统计学意义（P＜0.05）;治疗后观察组生理职能、社会功能以及角色功能评分高于对照组,差异有统计学意义（P＜0.05）;治疗后观察组10、20、30 d Lysholm评分高于对照组,差异有统计学意义（P＜0.05）。结论 在膝关节镜下半月板成形术治疗中提高训练频率有助于提升患者功能康复及生活质量,值得应用。     

关节腔内注射肿瘤坏死因子受体抗体融合蛋白对难治性类风湿关节炎患者关节积液情况、膝关节功能及ACPA水平的影响

目的 探讨关节腔内注射肿瘤坏死因子受体抗体融合蛋白[rhTNFR:Fc,益赛普(etanercept)]对难治性类风湿关节炎(RA)患者关节积液情况、膝关节功能及抗瓜氨酸肽抗体(ACPA)水平的影响。方法 选取我院收治的难治性RA患者为研究对象,分为两组。对照组患者给予甲氨蝶呤片等常规基础治疗,研究组在对照组基础上于患者关节腔内注射rhTNFR:Fc治疗,观察治疗后两组患者关节积液情况、膝关节功能及ACPA水平的变化。结果 研究组治疗有效率高于对照组(P<0.05)。治疗后,研究组患者关节积液深度、滑膜厚度低于对照组(P<0.05);VAS评分低于对照组(P<0.05);Lysholm膝关节功能评分高于对照组(P<0.05);血沉(ESR)、C反应蛋白(CRP)、ACPA水平低于对照组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 于难治性RA患者关节腔内注射rhTNFR:Fc疗效明显,能够减少关节积液量,改善膝关节功能,延缓病情发展。     

臭氧治疗膝关节骨性关节炎的疗效观察

目的探讨臭氧注射对膝关节骨性关节炎近期疗效。方法以138例膝关节骨性关节炎患者为研究对象,随机分为理疗对照组与臭氧治疗组。理疗组按处方要求给予中频加腊疗,50min/d,共2周;臭氧组按照操作程序向膝关节腔内注入浓度50%20ml臭氧,每周3次共6次,比较两组疼痛、关节活动度及Lysholm膝关节评分变化。结果经理疗及臭氧注射治疗后,两组疼痛减轻,膝关节活动度及Lysholm膝关节评分均提高（P〈0.05）。组间比较,臭氧组疼痛较理疗组显著减轻,Lysholm膝关节评分显著提高,但膝关节活动度的改善两者无统计学差异。结论臭氧注射相对理疗减轻疼痛与改善膝关节整体功能效果较好,但ROM的改善两者大致相当。     

Electromyographic evaluation of closed and open kinetic chain knee rehabilitation exercises

The use of closed kinetic chain knee rehabilitation exercises has been advocated in recent years. The primary reason cited for employing closed kinetic chain exercises is that these exercises result in less anteroposterior (A/P) shear force at the knee joint, when compared with traditionally used open kinetic chain exercises. The purpose of this study was to determine the electromyographical (EMG) activity ratio of quadriceps to hamstrings occurring in the following exercises: unilateral one quarter squats, leg extensions (N-K Table), lateral step-ups, and movements on the Fitter (Fitter International, Inc), Stair-master 4000 (Randal Sports/Medical Products, Inc), and slideboard. Ten female student-athletes participated in this study. EMG surface electrodes were applied over the rectus femoris and biceps femoris muscles. The subjects completed three maximum isometric contractions for both muscle groups to obtain baseline EMG data. They then performed repetitions of each exercise. These movements were videotaped simultaneously with a stationary shuttered video camera operating at 30 Hz. A computer program was used to analyze the videotaped performances for knee joint range of motion (ROM). Three trials of data were averaged. Baseline EMG activity was used to determine percentage of maximum EMG activity for each exercise. There were significant differences (p.<01) among the exercises for the following dependent variables: ROM, maximum angle, percent of maximum contraction, time of contraction, and total EMG (EMG area under the curve). This study suggests that the five closed kinetic chain exercises studied result in minimal A/P shear forces at the knee joint.     

Adaptation of a foot plate for use in an isokinetic and isotonic leg press

The use of isokinetic equipment and the leg press exercise have been major components of rehabilitation for the past several years when redeveloping muscular strength. Recently, closed kinetic chain exercises have been shown to be more beneficial and have less adverse affects on the knee when rehabilitating a patient's lower extremity. The purpose of this article is to introduce the leg press foot plate to the rehabilitative community. This foot plate is a versatile piece of equipment that has been adapted for use with various isokinetic, isometric, and isotonic devices in order to do leg press exercises. The device allows for closed kinetic chain strengthening and testing from equipment typically used only for open kinetic chain activities.     

HSS膝关节康复方案对单髁置换术后早期关节功能和步态的影响

目的 研究美国特种外科医院（hospital for special surgery, HSS）膝关节康复方案对膝关节单髁置换术（unicompartmental knee arthroplasty, UKA）术后关节功能及步态的近期影响。方法 回顾性分析2018年1月至2021年6月间在湖北省中医院行UKA术的60例患者。将采用HSS膝关节成形术康复指南进行康复治疗的30例患者作为HSS组;将同期采用常规康复方案的30例患者作为常规组。记录术后1周、3个月、6个月、1年两组患者的膝关节活动范围（range of motion, ROM）、美国特种外科医院膝关节HSS评分、人工关节遗忘指数（forgotten joint index, FJS）。分别于术后6个月、1年时采用GaitWatch三维步态分析及运动训练系统进行步态信息数据的采集,并比较两组间差异。结果 两组均完成术后1年以上随访,膝关节功能比较：术后3个月随访,HSS组膝关节ROM、HSS评分高于常规组,差异有统计学意义（P＜0.05）;术后6个月随访,HSS组患者膝关节ROM、HSS评分高于常规组,FJS评分低于常规组,差异有统计学意义（P＜0.05）;术后1年随访,HSS组的HSS评分高于常规组、FJS评分低于常规组,差异有统计学意义（P＜0.05）。步态参数比较：术后6个月随访,HSS组的步数、步长及单足支撑相较常规组高,差异有统计学意义（P＜0.05）;术后1年随访,HSS组的步数、步频、单足支撑相较常规组高,差异有统计学意义（P＜0.05）。结论 HSS膝关节成形术后康复方案在UKA术后早期可显著改善膝关节功能和步态,有利于UKA术后早期康复。     

A comparison of isokinetic and isotonic predictions of a functional task

Controversy still exists regarding the use of isokinetic and isotonic exercise in rehabilitation. Many authors have compared these two types of training methods on various strength measures and functional activity, but have used open kinetic chain training. The purposes of this investigation were to determine: 1) which form of closed kinetic chain training, isokinetic or isotonic, would produce the greatest increase in one-legged jump reaction force, and 2) which training method most accurately predicts peak force produced during a one-legged jump. Forty-two legs from 21 female volunteer subjects were used. Each subject had her dominant and nondominant extremities identified, and then each extremity was randomly assigned to either isokinetic training, isotonic training, or control. Both training groups trained using a leg press exercise 3 days a week for 5 weeks, while the control extremities did not train. The isokinetic extremities were trained using a velocity spectrum (two sets of 10 repetitions at each speed: 60 degrees , 180 degrees and 240 degrees /sec) and the isotonic extremities trained using the DAPRE technique. Data were analyzed with an analysis of variance (ANOVA). There was no difference between the three groups for change in one-legged jump force. Both isokinetic and isotonic groups increased strength after training, but these changes did not correlate with changes in one-legged jump reaction force. These results suggest that changes in neither isokinetic force nor isotonic weight lifted developed in a nonweight-bearing closed kinetic chain, directly translate into increased force production during a functional activity.     

Tibial displacement and rotation during seated knee extension and wall squatting: A comparative study of tibiofemoral kinematics between chronic unilateral anterior cruciate ligament deficient and healthy knees

BackgroundFollowing anterior cruciate ligament (ACL) rupture, the knee becomes unstable with alterations in joint kinematics including anterior tibial displacement (ATD), and internal tibial rotation. Therapeutic exercises that promote faulty kinematics should be discouraged, especially early post-reconstruction, to avoid graft stretching and possibly longer-term osteoarthritis. Our study aimed to compare ATD and tibial rotation during two commonly prescribed exercises, namely: open kinetic chain (OKC) seated extension and closed kinetic chain (CKC) single leg wall squatting in ACL-deficient and healthy knees.MethodsEight ACL-deficient patients and eight healthy subjects matched for age, gender and sports history were assessed using Qualisys 3D-Motion Analysis System to track 17 infrared markers while performing a seated knee extension with 3 kg weight and a unilateral wall squat. We developed a model to measure joint kinematics through 70° of knee flexion and extension. ANOVA and paired t-tests compared relative ATD and tibial rotation between exercises and groups at 10° increments of flexion and extension.ResultsWe found increased ATD in the wall squat compared to the seated extension (p = 0.049). There was no difference in ATD between the healthy and ACL-deficient knees but overall the tibia was significantly more internally rotated (p = 0.003) in ACL-deficient knees, irrespective of the exercise, possibly interfering with the screw-home mechanism.ConclusionsCKC exercises, in particular wall squats, are not necessarily safer for patients with ACL-deficiency and possibly ACL-reconstruction; although generalization should only be made with appropriate caution. Clinicians require a detailed knowledge of the effect of exercise on knee joint kinematics.     

温针灸与针刺治疗老年性膝骨关节病的临床疗效对比

目的 探究温针灸与针刺治疗老年性膝骨关节病的临床疗效。方法 选取我院2015年1月~2017年1月收治的老年性膝骨关节病患者110例,按随机数字表法分为实验组和对照组,每组55例。实验组采取温针灸疗法,对照组采取针刺治疗。对比两组患者治疗有效率、治疗前后膝关节评分和疼痛量表评分。结果 实验组治疗有效率为94.55%,高于对照组的74.55%,差异具有统计学意义（P＜0.05）。治疗后1周、2周,实验组膝关节HSS评分均高于对照组,差异具有统计学意义（P＜0.05）。治疗后1周,实验组膝关节ROM评分为（82.24±9.46）分,高于对照组的（75.24±9.32）分,差异具有统计学意义（P＜0.05）;治疗2周,两组膝关节ROM评分对比,差异无统计学意义（P＞0.05）。治疗前后,两组间疼痛量表VAS评分及评分差值对比,差异均无统计学意义（P＞0.05）。结论 与针刺治疗相比,温针灸能在较短时间内缓解患者膝骨关节疼痛,且治疗方式较适宜老年患者。     

Evaluation of proprioception in patients who underwent ACL reconstruction: measurement in functional position

Background/aimAnterior cruciate ligament (ACL) injuries cause mechanoreceptor loss in the joint; therefore, proprioceptive deficits are observed after injury. In particular, proprioceptive measurements made in the functional position give more accurate results, and this is an area that requires further studies. This study aimed to evaluate proprioception in patients who had undergone ACL reconstruction (ACLR) in functional positions used in daily life (closed kinetic chain position), according to joint angles where ACL injuries occur more frequently, in comparison with healthy controls.Materials and methodsThirty-four participants who underwent ACLR using a hamstring tendon graft (aged 29.18 ± 8.16 years; body mass index (BMI), 26.58 ± 4.02 kg/cm²) and 31 healthy participants (aged 27.35 ± 5.74 years; BMI, 24.76 ± 2.98 kg/cm²) were included. Proprioception was assessed with an active angle repetition test, using an inclinometer in the closed kinetic chain position while standing. Participants were asked to perform single-leg squats until the angle at the knee joint was 30°. After the targeted angle was defined, the participants were asked to find the targeted angle. The difference between the targeted angle and the angle reached by the participants was calculated.ResultsA statistically significant difference in the active joint position sense was found among the ACLR extremity, uninvolved extremity, and control extremity (p < 0.05). The proprioceptive sense between the two extremities in the ACLR group was similar, and the proprioceptive sense was worse than that of the control group.ConclusionTo our knowledge, this is the first study to evaluate closed kinetic chain position in patients who underwent ACLR, and it showed that proprioceptive sense was still poor in patients with ACLR compared with the control group, even if an average of 24 months have elapsed since surgery.     

The effect of unilateral and bilateral strength training on the bilateral deficit and lean tissue mass in post-menopausal women

Some have observed maximal strength of simultaneous bilateral homologous limb contraction is less than the sum of strengths of right and left limbs contracting alone; a phenomenon referred to as the bilateral deficit (BLD). There is controversy on whether there is a BLD for all exercises. We assessed whether a BLD occurs across different exercises (leg press, knee extension, and lat pull-down), whether the BLD could be altered with unilateral or bilateral training, and whether unilateral versus bilateral training was more beneficial for increasing lean tissue mass (LTM). Post-menopausal women (~57 years) were randomized to bilateral (n=14) and unilateral (n=12) training, or non-training control (n=24) groups. Bilateral training involved seven exercises performed with bilateral contractions (two sets, 3 days week⁻¹, 26 weeks). Unilateral training involved the same exercises performed with one limb at a time. A BLD was found for leg press and lat pull-down, but not for knee extension. Bilateral training decreased the BLD; whereas unilateral training had minimal effect on the BLD. The unilateral-training group had a greater increase in lower-body LTM compared to the control group (P<0.05); however, there were no differences between unilateral and bilateral training groups. Both training groups had greater increases in LTM of the upper- and whole-body compared to the control group. We conclude that the BLD is apparent for some exercises (i.e., the leg press and lat pull-down) but not others (i.e., knee extension). Bilateral training reduces the BLD; whereas unilateral training has minimal effect on the BLD.     

等速限弧运动对膝关节炎功能影响

目的　探讨股四头肌限弧等速运动角度对膝骨性关节炎患者的疗效。 方法　共78例右膝骨性关节炎患者纳入研究，按随机法赋值从大到小分成3组，每组26例。3组除常规运动训练外，进行不同角度的限弧等速运动训练。训练弧度分别为：A组膝屈90°→10°，B组膝屈60°→10°，C组膝屈30°→10°。每周3 次, 训练 8 周。在治疗前后分别采用疼痛视觉模拟评分法（VAS）评估疼痛改善程度，采用美国特种外科医院（HSS）指数评定膝关节功能情况，同时等速训练仪测定患膝峰力矩（peak torque，PT）、本体感觉误差均值。 结果　3组疼痛、HSS指数、PT较治疗前差异有显著性意义（P <0.05），A组优于B组、C组（P <0.05）；治疗后各组本体感觉较治疗前略有改善，但3组改善程度无统计学差异（P> 0.05）。 结论　不同弧度等速运动可以改善膝关节功能，较大弧度的限弧等速运动获益更明显。