膝骨关节炎与膝关节伸、屈肌群肌力的相关性研究

目的通过研究膝骨关节炎(knee osteoarthritis,KOA)症状及病变阶段与膝关节伸、屈肌群肌力的相关性,探讨KOA患者肌力训练的关键肌群。方法社区募集健康老年人、单膝KOA患者、双膝KOA患者共99位志愿者,应用膝关节等速肌力测试、WOMAC评分、6 min步行测试、CS-30测试,分析志愿者膝关节伸、屈肌群峰力矩与KOA症状、全身有氧运动能力、关节功能等的相关性。结果单膝KOA组患者患侧膝关节伸肌群等速峰力矩显著低于健侧。双膝KOA组患者症状严重侧和症状较轻侧膝关节伸、屈肌群等速峰力矩差异均有统计学意义。双膝KOA组患者膝关节伸肌群等速峰力矩显著低于健康组。KOA患者膝关节伸、屈肌群等速峰力矩与CS-30测试、6 min步行测试均呈正相关,均与年龄呈负相关;膝关节伸肌群等速峰力矩与WOMAC评分的疼痛和功能障碍项呈负相关。结论膝关节伸、屈肌群均与KOA相关,KOA康复过程中不仅需重视股四头肌等伸肌群的训练,而且要兼顾腘绳肌、腓肠肌等屈肌群的训练。

Correlation study on knee extensor/flexor strength and knee osteoarthritis

Objective To determine key muscles during muscle strength training of patients with knee osteoarthritis (KOA) by studying the correlation of KOA symptoms and disease stages with knee extensor/flexor strength. Methods Ninety-nine community volunteers were recruited and stratified into healthy group, single KOA group, and bilateral KOA group. The relationship between isokinetic extensor/flexor strength and KOA symptom, full-body aerobic exercise capacity, joint function were analyzed by knee isokinetic muscle strength test, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), 6-minute walk test, and CS-30 test. ResultsKnee isokinetic extensor peak torque of the symptomatic leg was significantly lower than that of the asymptomatic leg in single KOA group. There were significant differences in knee isokinetic extensor/flexor peak torque of both the severe and mild symptomatic leg in bilateral KOA group. Knee isokinetic extensor peak torque in bilateral KOA group was significantly lower than that in healthy group. Knee isokinetic extensor/flexor peak torque of KOA patients was positively related to 6-minute walk test, CS-30 test, while negatively related to age. Knee isokinetic extensor peak torque was negatively related to pain score and physical function score of WOMAC. Conclusions Both knee extensor and flexor strength are related to KOA. Therefore, during KOA rehabilitation therapies, muscle training for knee extensors (particularly quadriceps femoris muscles) and knee flexors (hamstring muscles, gastrocnemius muscles) need to be valued.