等速训练联合五禽戏对膝骨关节炎肌力的影响及远期疗效

目的:观察推拿结合等速运动训练配合五禽戏对膝关节骨性关节炎患者屈伸肌力的影响及远期疗效。方法:选取2016年12月-2019年1月在福建省第二人民医院就诊的KOA患者180例,随机分成三组:A组(推拿+等速训练+五禽戏),B组(推拿+等速训练),C组(推拿+五禽戏),每组各60例。三组均隔日治疗1次,连续治疗10次。比较三组治疗前后的VAS评分、Lysholm评分、膝关节屈伸肌力和临床总疗效,以及6个月随访时的VAS评分、Lysholm评分、复发率。结果:三组KOA患者的临床疗效A组最佳(P<0.05),B、C组次之(P>0.05)。治疗后三组的VAS、Lysholm评分与治疗前比较有非常显著差异(P<0.01),VAS评分组间比较没有统计学意义(P>0.05),Lysholm评分组间两两比较A>B=C。膝关节屈伸肌群的峰值力矩治疗前后比较差异有非常显著统计学意义(P<0.01),治疗后组间比较差异有非常显著统计学意义(P<0.01),且A>B>C。6个月随访显示VAS、Lysholm评分组间两两比较A>B=C,复发率比较A>B=C。结论:推拿结合等速运动训练配合五禽戏治疗KOA是一种行之有效的优化方案,可以提高膝关节的屈伸肌力,进而增强关节的稳定性,降低复发率,远期疗效确切,值得临床推广。

Effect of Isokinetic Training Combined with Wu Qin-xi on Muscle strength of knee osteoarthritis and Long-term Effect

Objective:To observe the effect of massage combined with isokinetic exercise training and Wuqinxi on the flexor and extensor strength of patients with knee osteoarthritis and the long-term effect.Methods:A total of 180 KOA patients who were treated at the Second People’s Hospital of Fujian Province from December 2016 to January 2019 were selected and randomly divided into three groups:Group A(Tuina+Isokinetic Training+Wu Qin Xi)and Group B(Tuina+Isokinetic Training)Training,Group C(Tuina+Wu Qin Xi),60 cases in each group.The three groups were treated every other day for 10 consecutive treatments.The VAS score,Lysholm score,knee flexor and extensor strength,and total clinical efficacy of the three groups before and after treatment were compared,as well as the VAS score,Lysholm score,and recurrence rate at the 6-month follow-up.Results:The clinical efficacy of the three groups of KOA patients was the best in group A(P<0.05),followed by groups B and C(P>0.05).The VAS and Lysholm scores of the three groups after treatment were significantly different from those before treatment(P<0.01),the comparison of VAS scores between groups was not statistically significant(P>0.05),and Lysholm scores were compared in pairs between groups A>B=C.The peak torque of the knee flexors and extensors before and after treatment has a very significant statistical difference(P<0.01),and the difference between the groups after treatment has a very significant statistical significance(P<0.01),and A>B>C.The 6-month follow-up showed that a pairwise comparison between the VAS and Lysholm score groups was A>B=C,and the recurrence rate was A>B=C.Conclusion:Tuina combined with isokinetic exercise training combined with Wuqinxi to treat KOA is an effective and optimized plan,which can improve knee joint flexor and extensor strength,thereby enhancing joint stability and reducing recurrence rate.The long-term curative effect is definite and worthy of clinical promotion.