弹力带渐进抗阻训练对膝关节置换术后患者下肢运动功能的影响

摘要

Objective:To evaluate the effect of elastic band resistance training program on co-contraction index (CCI),visual analogue scale (VAS) and 6-minute walking test in patients with unilateral knee arthroplasty (TKA).Method:Twenty-seven patients who underwent TKA were randomly assigned into two groups:elastic band resistance training group (group A,n=14) and isometric resistance training group (group B,n=13).The CCI,VAS and 6MWT were assessed at baseline (T0),6 weeks after the training(T1) and 12 weeks after the training (T2) respectively.Result:After 12 weeks training,all the patients had significant increases in 6MWT and decreases in VAS,CCI (P＜0.05).In group A,when compared T2 with Tl,both VAS and CCI decreased significantly (P＜0.05).In group B,there were no significant differences for the indexes between T2 and T1.In addition,there were more decrement in CCI and VAS,increment in 6MWT in group A.Conclusion:Elastic band resistance training program,which was more effective compared with isometric resistance training,had positive effect on releasing pain,improving CCI and walking ability for TKA patients.%目的:探讨弹力带渐进抗阻训练对单膝关节全膝关节置换术后患者下肢运动功能的影响.方法:选取27例全膝关节置换术后患者,分为渐进抗阻训练组(A组)和等张肌力训练组(B组),分别于研究开始(T0)、6周后(T1)、12周后(T2)采集患者单足支撑相患肢股外侧肌和股二头肌表面肌电信号(拮抗收缩指数,CCI),VAS,6MWT.对上述数据进行组间及组内比较.结果:经过6周的渐进抗阻训练,A组患者VAS、CCI明显降低(p＜0.05),6MWT明显增加(P＜0.05);在随后的6周训练后,A组患者VAS、CCI持续降低(P＜0.05),6MWT继续增加(P＜0.05).经过6周的等张肌力训练,B组患者6MWT、VAS、CCI均无明显变化;经过12周的等张肌力训练,B组患者VAS、CCI明显降低(P＜0.05),6MWT明显增加(P＜0.05)等张肌力训练组;但上述指标在T1与T2间无明显差异.经过12周的肌力训练,渐进抗阻训练组CCI、VAS明显低于(P＜0.05),6MWT明显大于(P＜0.05)等张肌力训练组.结论:抗阻肌力训练能有效改善TKA患者下肢肌肉协同收缩模式,缓解疼痛,提高功能活动能力.与等张抗阻训练相比,弹力带渐进抗阻训练在改善TKA术后下肢运动控制,缓解疼痛,提高活动能力方面更具优势.