等速训练在股骨骨折制动后膝关节僵硬康复中的应用

目的探讨等速训练在骨折制动后膝关节僵硬康复中的效果。方法选择本科住院及门诊骨折患者38 例，按就诊顺序分为观察组(n=19)和对照组(n=19)。两组均采用中药熏蒸和关节松动术治疗。观察组在此基础上加等速训练，对照组在此基础上加器械训练(股四头肌训练椅)。治疗前及治疗16 周后，观察两组膝关节活动度、屈伸肌群最大峰力矩、峰力矩与体重比、平均功率、屈伸肌肌力比值的变化情况。结果治疗后两组关节屈曲度、伸直度、屈伸弧均显著优于治疗前(P<0.001)，治疗后观察组关节屈曲度、屈伸弧增加度均显著高于对照组(P<0.001)；等速测试结果比较，两组除屈伸肌肌力比值外其余各项指标均显著优于治疗前(P<0.001)，治疗后观察组膝关节活动度、屈伸肌群最大峰力矩、峰力矩与体重比、平均功率较治疗前显著改善(P<0.001)，而两组治疗后屈伸肌肌力比值无显著性差异(P>0.05)。结论等速训练在骨折制动后膝关节僵硬的康复中有很好的治疗作用。

Effect of Isokinetic Training on Stiff Knees after Fracture Immobilization of Femur

Objective To investigate the effect of isokinetic training on stiff knees after fracture arrest.Methods 38 fracture patients were divided into observation group(n=19) and control group(n=19) by the medical number.Both 2 groups received the Chinese herbs fumigation and joint mobilization.Besides,the observation group received the isokinetic training,while the control group received the instrument training.The range of motion(ROM),maximum peak torque(PT),peak torque/body weight(PT/BW),average power(AP),and hamstrings/quadriceps(H/Q) were tested before and 16 weeks after training.Results The flexion,straightness and flexion radian became significantly better after training.The flexion and the increase of the flexion radian were significantly better in observation group than in control group after training.All indexes of the isokinetic test significantly improved after training(P<0.001) except H/Q(P>0.05).ROM、PT、PT/ BW and AP of the knees joint were significantly better in the observation group than in the control group(P<0.001) after training,while there was no significant difference in H/Q between 2 groups(P>0.05) after training.Conclusion Isokinetic training can promote recovery of stiff knees of femur fracture.