膝骨关节炎患者平衡功能下降的影响因素分析

目的 明确膝骨关节炎(knee osteoarthritis,KOA)患者平衡功能下降的主要影响因素.方法 对89例KOA患者进行人口统计学基本信息采集、视觉模拟疼痛评分(visual analogue pain scale,VAS)、患膝关节的影像学分级、稳定极限测试(limits of stability,LOS)及双下肢的反应性测试、位置觉测试和等速肌力测试.结果 以年龄为控制因素,经Pearson偏相关分析发现患膝的VAS评分、反应时间、整体反应时间、复位误差平均值和60°峰力矩与LOS总分密切相关(P<0.05);经多元线性回归分析发现,患膝的复位误差平均值、60°伸肌峰力矩和反应时间是LOS总分的主要影响因素(P<0.01).结论 超重、膝关节疼痛、KOA病程、膝关节影像学分级不是导致KOA患者平衡功能下降的主要影响因素,而因膝关节疼痛导致的下肢肌力下降、本体感觉减退和患膝关节对新刺激做出知觉反应能力的减慢是导致KOA患者平衡功能较之无KOA者更差的疾病自身特征性主要影响因素.

Influential factors of declined balance function in elderly patients with knee osteoarthritis

Objective To investigate the major Influential factors of declined balance function in the elderly patients with knee osteoarthritis(KOA).Methods Eighty-nine elderly patients with KOA were tested with visual analogue pain scale(VAS),limits of stability(LOS),reaction time(RT),knee joint position sense,and isokinetic muscle strength.At the same time,their basic demographic information and the unaffected knees’ radiological grades were collected.Results Under the premise of the age as a controlling factors,after the Pearson partial correlation analysis,we found that the total LOS score was closely correlated with the unaffected knees’ factors such as VAS scores,RT,total response time(TRT),the reposition accuracy error mean and 60o of peak torque(P<0.05).And then after the multiple regression analysis,we found that the unaffected knees’ reposition accuracy error mean,60o of peak torque and RT among the above factors were major factors of the total LOS score(P<0.001).Conclusions Overweight,knee pain,course of knee osteoarthritis,and knees’ radiological grades are not major influential factors that result in the declined balance function in the elderly patients with KOA.Compared with the balance function of the elderly people without KOA,that of the elderly patients’ with KOA is worse.Whereas decreased lower extremity muscle strength resulting from knee pain,proprioception loss and slower sense reaction to new stimuli resulting from affected knee are the main characteristic influential factors of the declined balance function in the KOA patients.