不同收缩方式的血流限制训练对膝关节骨性关节炎患者股内侧肌功能及形态学的影响观察

目的 观察不同收缩方式的血流限制(BFR)训练对膝关节骨性关节炎(KOA)患者股内侧肌(VMO)功能及形态学的影响。方法 招募2021年6月至2023年6月昆明市中医医院收治的KOA患者108例，采用随机数字表法将其分为A观察组、B观察组和对照组，每组36例。对照组采用VMO等张收缩训练，A观察组采用VMO等长收缩结合BFR训练，B观察组采用VMO等张收缩结合BFR训练。比较三组治疗前后视觉模拟量表(VAS)评分、大腿围度、VMO厚度以及VMO肌电值[包括均方根(RMS)值和积分肌电(iEMG)值]。结果 在治疗3周后，三组左膝及右膝VAS评分与治疗前相比均显著降低(P<0.05),左、右大腿围度、VMO厚度、iEMG值和RMS值与治疗前相比均显著上升(P<0.05),且B观察组和A观察组的指标改善情况优于对照组(P<0.05),以B观察组指标改善更显著(P<0.05)。结论 BFR训练能有效改善KOA患者的关节疼痛，增加VMO厚度和大腿围度。在低负荷BFR条件下，等张收缩训练的康复治疗效果优于等长收缩训练。

Observation on the effects of blood flow restriction training with different contraction modes on the function and morphology of vastus medialis oblique in patients with knee osteoarthritis

［Abstract］　Objective　To observe the effects of blood flow restriction(BFR) training with different contraction modes on the function and morphology of vastus medialis oblique(VMO) in patients with knee osteoarthritis(KOA). Methods　A total of 108 patients with KOA who were admitted to Kunming Municipal Hospital of Traditional Chinese Medicine from June 2021 to June 2023 were recruited and divided into observation group A, observation group B and control group by using random number table method, with 36 cases in each group. The control group received isotonic contraction training of VMO, and the observation group A received isometric contraction training of VMO combined with BFR training, and the observation group B received isotonic contraction training of VMO combined with BFR training. Visual Analogue Scale(VAS) scores, thigh circumference, VMO thickness, and VMO electromyographic values［including root-mean-square(RMS) value and integrated electromyography(iEMG)］ were compared among the three groups before and after treatment. Results　After 3 weeks of treatment, VAS scores of the left knee and the right knee in the three groups were significantly decreased compared with those before treatment(P<0.05), and the circumferences of the left thigh and the right thigh, VMO thickness, iEMG value and RMS value were significantly increased compared with those before treatment(P<0.05), and the improvements of the indicators in the observation group B and the observation group A were better than those in the control group(P<0.05), and the indicators in the observation group B were more significantly improved(P<0.05). Conclusion　BFR training can effectively improve joint pain, increase VMO thickness and thigh circumference in KOA patients. Under the condition of low load BFR, the rehabilitation treatment effect of isotonic contraction training is better than that of isometric contraction training.