渐进抗阻肌力训练在膝骨关节炎康复治疗中股四头肌表面肌电的表现.docVIP

渐进抗阻肌力训练在膝骨关节炎康复治疗中股四头肌表面肌电的表现 　　【摘 要】目的：观察渐进抗阻在膝骨关节炎康复训练中对股四头肌肌力恢复的疗效。方法：将60例膝骨关节炎患者随机分为治疗组和对照组，每组30例。对照组采用股四头肌训练椅治疗，治疗组采用弹力带渐进抗阻肌力训练治疗。2组疗程均为4周。治疗前后分别采用徒手肌力测量及表面肌电图测试伸膝肌肉（股直肌、股内侧肌、股外侧肌）表面肌电平均活动波幅均值。结果：治疗后，2组徒手肌力测量值较治疗前均有升高（P 0.05）；2组间比较，差异无统计学意义（P 0.05）。2组表面肌电平均活动波幅均值较治疗前均有改善（P 0.05），且治疗组优于对照组（P 0.05）。结论：渐进抗阻肌力训练能更好地增强肌力，在膝骨关节炎康复方面具有极大地推广应用价值。 　　【关键词】 骨关节炎，膝；渐进抗阻；肌力训练；表面肌电信号 　　【ABSTRACT】Objective：To observe the effect of progressive resistance strength training on quadriceps femoris muscle in the rehabilitation training of knee osteoarthritis.Methods：60 cases of knee osteoarthritis were randomly divided into two groups：a treatment group and a control group，30 cases in each.The control group was treated with training chair，and the treatment group was treated with progressive resistance strength training.The two groups were treated for 4 weeks.Before and after treatment，the average amplitude of the average activity of the extensor muscle（rectus，medial and lateral thigh）was measured by hand muscle strength and surface electromyography （EMG）.Results：After treatment，the hand-measured values of the two groups were increased compared with those before treatment （P 0.05）.The difference between them was not statistically significant （P 0.05）.The mean activity amplitude of the two groups was better than that before treatment （P 0.05），and the treatment group was better than the control group （P 0.05）.Conclusion：Progressive resistance strength training can enhance muscle strength and has a great application value in the rehabilitation of knee osteoarthritis. 　　【Keywords】 osteoarthritis，knee；progressive resistance；muscle strength training；surface electromyography signal 　　膝骨关节炎（knee osteoarthritis，KOA）是以关节软骨退变、骨赘形成为主要病理特征的慢性关节疾病[1]。临床表现多为关节疼痛，并因肿胀导致关节活动受到不同程度的限制，从而造成膝关节周围肌群特别是股内侧肌、股直肌、股外侧肌肌力明显下降。KOA患者最终治疗上采用手术方式能够取得更好的疗效[2]，但初期骨关节退变患者若无手术指征，可加强股四头肌肌力训练，以维持关节稳定性，延缓KOA进程。徒手肌力测定（MMT）在评估肌力恢复的效果方面主观性较强，不具有他人操作性[3]；而肌电信号（EMG）蕴涵了很多与人体动作相关联的信息[4]。本次观察旨在通过表面肌电信号对比评估渐进抗