神经功能异常屈伸膝肌的等速运动训练

目的　了解常用等速肌力训练方案对伴神经异常性屈、伸膝肌力的影响。方法　伴神经异常和单纯骨关节伤病后的患者各16例，用Cybex330型等速运动仪评定(60°/s)双侧膝关节，用60°/s～180°/s，间隔30°/s，由慢至快，再由快至慢训练患肢。记录训练前后屈膝峰力矩(PT-F)、伸膝峰力矩(PT-E)、屈肌/伸肌(F/Q)比率和患侧差值%，计算平均每周肌力的变化率，利用方差分析重复测量设计比较两组间和训练前后的差异有无显著性。结果　①训练后PT-F和PT-E均提高，每周PT-F和PT-E的变化率均较各自健侧大，但神经异常组的变化率显著低于对照组(PT-FF＝8.82，P＜0.01；PT-EF＝4.99，P＜0.05)；②训练后PT-F和PT-E患侧差值%均减小，神经组减小幅度分别为3.7%和4.4%，对照组分别减小11.0%和13.4%，对照组训练后PT-F和PT-E的差值%显著低于训练前(PT-FF＝6.40，P＜0.01；PT-EF＝22.69，P＜0.01)；③训练后F/Q比率均显著减小(F＝7.07,P＜0.05)，但患侧还显著大于健侧(F＝13.07，P＜0.01)，两组间差异无显著性(F＝0.95，P＞0.05)。结论　等速运动训练可用于增强伴神经异常肌的肌力和提高膝关节的稳定性，但所用速度谱对提高神经异常肌肉的肌力不及一般废用性肌肉。

Isokinetic training forknee extensor and flexor after partial denervation or hemiplegia

Objective　To study the effect of isokinetic training on knee extensor and flexor with nerve function abnormality caused by partial denervation or hemiplegia.Methods　Both knees of 16 cases with nerve function abnormality and 16 cases with traumatic osteoarthropathy were evaluated by Cybex 300(60°/s) before and after isokinetic training.The angular velocity began at 60°/s,90°/s,120°/s,150°/s to 180°/s,from here the velocity was gradually descended to 60°/s.Each speed repeated 10 times.Before and after training,peak torque-flexor(PT-F),peak torque-extensor(PT-E),F/Q ratio and difference in % of involved knees were recorded.The change rate of mean muscle strength per week was calculated.The design method was repeatedly measured using analysis of variance to compare the difference in both groups.Results　After training:1.The PT-F and PT-E were enhanced.The change rate of PT-F and PT-E in involved knees per week was greater than that of uninvolved knees,but that of abnormal nerve group was obviously lower than that of the control group(PT-F:F＝8.82,P＜0.01;PT-E:F＝4.99，P＜0.05).2.The difference in % of PT-F and PT-E in involved knees all was decreased,the reducing amplitude in abnormal nerve group was respectively 3.7% and 4.4% vs. the 11.0% and 13.4% of control group.The difference in % of PT-F and PT-E in control group after training was markedly lower than before(PT-F:F＝6.40,P＜0.01;PT-E:F＝22.69,P＜0.01).3.F/Q ratio all was significantly decreased in two groups,but there wasn't obvious difference(F＝0.95,P＞0.05).Conclusion　The study suggests that isokinetic training can improve the muscle strength of nerve function abnormality and stabilize the knee joints in partial denervation and hemiplegia.