关节镜术后等速训练对膝半月板损伤恢复的影响

背景:运动损伤后的康复训练是保持和减缓运动能力的重要途径,开展此领域的研究具有重要意义。目的:观察膝半月板损伤施以关节镜手术后,等速训练对膝关节功能恢复及关节周围肌肉力量的影响。设计:病例-对照观察。单位:辽宁警官高等专科学校警训系。对象:于2004-09/2005-01选择大连医科大学附属医院外科收治的单侧膝关节半月板急性损伤患者22例为观察对象。随机数字表法分为实验组和对照组,各11例。方法:实验组和对照组患者进行关节镜手术治疗,对照组进行常规封闭、理疗、按摩等方法恢复。实验组患者术后第2～4天开始功能恢复,3周后采用Cybex-6000型等速运动测试仪对患侧膝屈伸肌进行等速运动训练。主要观察指标:不同测试速度[60,120,180(°)/s]时的屈伸肌峰力矩、单次最大做功量、力矩加速能、平均功率。结果:纳入患者22例,均进入结果分析。①关节镜手术配合等速肌力训练后,膝关节运动范围加大,训练前患膝的最大屈曲角度为(132±25)°,训练后患膝的最大屈曲角度为(158±21)°,经配对t检验,两者差异有非常显著性意义(P<0.01)。而对照组手术后最大屈曲角度为(133±31)°,实验结束后最大屈曲角度为(139±34)°,差异无显著性意义(P>0.05)。且两组实验后差异有显著性意义(P<0.05)。②实验组膝屈伸肌峰力矩、单次最大做功量、力矩加速能及平均功率在60,120,180(°)/s的变化与对照组相比差异均有显著性意义(P<0.05)。结论:膝关节等速训练,可加速膝半月板损伤后的康复过程,对增加膝关节周围肌肉力量、保持膝关节的稳定性和运动能力均具有重要的意义。

Effect of isokinetic training on the function recovery of knee meniscus injuries following arthroscope

BACKGROUND: Rehabilitation training after sports injury is of so great importance in the remaining and relieving of exercise ability that the researches in thisfield need to develop.OBJECTIVE: To evaluate the influence of isokinetic training on the functional recovery of knee flexors and extensors and the muscle force around the joint after knee meniscus injuries receiving arthroscopy.DESIGN: Case-control observation SETTING: Department of Police Training, Liaoning Advanced Police Officer School PARTICIPANTS: A total of 20 patients with acute meniscus injury of lateral knee joint were selected from the Department of Surgery, Affiliated Hospital of Dalian Medical University between September 2004 and January 2005. They were randomly divided into experimental group and control group,including 11 cases respectively. METHODS: All the patients were treated with arthroscope operation, additionally the control patients received routine blocking, physiotherapy and massage, etc. To recover the function. From the 2nd to 4th days postoperative, the patients of experimental group began to carry out the functional rehabilitation, and received isokinetic exercise in both knees flexors and extensors with the Cybex-6000 isokinetic dynamometer 3 weeks later.MAIN OUTCOME MEASURES: Peak torque values, total work, torque accelerating energy and average power in both knee flexors and extensors at different angular velocities [60, 120 and 180(°)/s].RESULTS: A total of 22 patients were involved in the result analysis.①After arthroscope operation and isokinetic training, the range of joint movement were extended, and the maximum flexion angle changed from (132±25)° to (158±21)°. There were significant differences before and after training by t test (P ＜ 0.01).②The experimental group had statistical significance compare with control group in the test index at 60, 120 and 180(°)/s(P ＜ 0.05).CONCLUSION: The arthroscope combining with isokinetic training can speed up the rehabilitation after knee meniscus injury, enhance the muscle force around knee joint and maintain the stability of knee joint and motor ability.