推拿结合等速肌力训练治疗膝关节骨性关节炎临床疗效研究

目的:观察推拿治疗结合等速肌力训练对膝关节骨性关节炎的治疗效果。方法:从膝关节骨性关节炎(KOA)患者中随机选取60例作为观察对象,60例患者随机分为推拿结合等速治疗组(试验组)和单纯推拿治疗组(对照组)。分别将两组治疗前后的膝关节西安大略和麦克马斯特大学骨关节炎指数(WOMAC)、等速屈伸肌力测试对比分析。结果:两组治疗后膝关节WOMAC评分均较治疗前有显著改善(P0.01),其中推拿结合等速组膝关节WOMAC评分由(62.93±16.17)降为(26.20±12.68),改善较单纯推拿组更为显著(P0.01)。两组治疗干预前等速肌力测试各指标比较没有显著性差异。经过8周治疗后推拿加等速训练组膝关节伸肌峰力矩、峰力矩/体重、达峰时间、平均功率,膝关节屈肌峰力矩、达峰时间与本组治疗前比较明显改善,差异有显著性(P0.01);膝关节伸肌平均功率与本组治疗前比较有改善,差异有显著性(P0.05);推拿加等速训练组膝关节伸肌峰力矩、峰力矩/体重、达峰时间、膝关节屈肌达峰时间、屈肌/伸肌比单纯推拿组治疗后改善明显,差异有显著性(P0.05);推拿加等速训练组膝关节屈肌峰力矩与单纯推拿组治疗后比较提高明显,差异有显著性(P0.01)。结论:推拿结合等速肌力训练可以提高KOA患者膝关节屈伸肌肉力量,对于KOA的治疗具有良好的临床疗效,且明显优于单纯推拿治疗。

The clinical effect of tuina combined with isokinetic muscle training on knee osteoarthritis

Abstract Objective: To study the clinical effect of tuina combined with isokinetic muscle training on knee osteoarthritis. Method: Sixty patients with knee osteoarthritis were randomly divided into tuina group and tuina combined with isokinetic muscle training group. We analysed and compared the knee WOMAC scores and isokinetic muscle strength testing before and after the 8 weeks treatment. Result: After 8 weeks treatment, knee WOMAC scores were significantly improved (P<0.01) for both groups. In the tuina combined with isokinetic muscle training group, WOMAC score was reduced from (62.93±16.17) to (26.20±12.68), more obviously than that of the tuina group (P<0.01). Before treatment, each index for the isokinetic muscle testing had no significant different between two groups. After 8 weeks treatment, tuina combined with isokinetic training group showed obviously improved knee extensor''s peak torque, peak torque/weight, time to peak torque, average power, knee flexor''s peak torque and time to peak torque compared with those before treatment (P<0.01); After treatment, knee extensor average power was improved with significant difference (P<0.05). In the tuina combined with isokinetic training group, the knee extensor''s peak torque, peak torque/weight, time to peak torque, knee flexor''s time to peak torque and flexor/extensor improved obviously than those in the pure tuina group after treatment (P<0.05). The knee flexor''s peak torque of tuina combined with isokinetic training group increased obviously, compared with the tuina group (P<0.01). Conclusion: Tuina combined with isokinetic muscle training can improve the power of knee flexors and extensors. It''s a better method to treat knee osteoarthritis.