Effect of Preoperative Low Intensity Slow Motion Training on Quadriceps Femoris Muscle Strength in Patients with Knee Osteoarthritis after Total Knee Arthroplasty
FU Xiao-wei, SHAO Zheng-hai, XU Cai-xia, et al
Department of orthopedics, Shanghai Changhang hospital, Shanghai, 200122, China
摘要【目的】探讨术前低强度慢动作训练(LST)对膝骨性关节炎患者全膝关节置换术(TKA)术后早期股四头肌肌力的影响。【方法】选择2015年1月至2020年12月在上海长航医院及上海开元骨科医院行TKA手术的膝骨性关节炎患者86例,按照随机数表法分为对照组和观察组,每组43例。对照组术前给予药物治疗,观察组在对照组的基础上术前给予LST训练。比较两组患者术前4周、术前1 d和术后股四头肌肌力(QST)、起立-行走计时测试时疼痛程度(VAS)、膝围[髌骨上1 cm处膝围(1 cm KC)和髌骨上10 cm处膝围(10 cm KC)]、大腿体积(TV)等,检测并比较两组患者血清超氧化物歧化酶(SOD)、丙二醛(MDA)、肿瘤坏死因子α(TNF-α)和白细胞介素-1β(IL-1β)水平。【结果】两组患者手术时间和术中出血量比较差异均无统计学意义(P<0.05)。术前4周,两组患者QST比较差异无统计学意义(P>0.05);术前1 d,观察组患者QST高于对照组(P<0.05),两组患者术后4 d QST均显著低于术前1 d和术前4周(P<0.05),但观察组术后QST高于对照组(P<0.05)。两组患者术后1 cm KC、10 cm KC和TV均较术前4周和术前1 d显著升高(P<0.05),但观察组患者上述指标均低于对照组(P<0.05)。两组患者术后QST检测期间VAS、起立-行走计时测试期间VAS和起立-行走计时均较术前1 d显著升高(P<0.05),但观察组上述指标均显著低于同期对照组(P<0.05)。观察组术后SOD高于对照组,MDA、TNF-α、IL-1β水平低于对照组,差异均有统计学意义(P<0.05)。【结论】LST可改善TKA患者术后股四头肌力量,减轻术后膝部和大腿肿胀,降低患者疼痛程度,耐氧化应激能力增强,值得临床推广应用。
Abstract：【Objective】To investigate the effect of preoperative low-intensity slow motion training (LST) on quadriceps femoris weakness in patients with knee osteoarthritis after total knee arthroplasty (TKA). 【Methods】 A toal of 86 patients with knee osteoarthritis to be treated with TKA in Shanghai Changhang hospital and Shanghai Kaiyuan Orthopedic Hospital from January 2015 to December 2020 was selected as the research object. The patients were randomly divided into control group and LST group, with 43 cases in each group. The control group was given drug treatment, and the LST group was given LST training on the basis of the control group. The quadriceps femoris strength (QST), pain degree (VAS), knee circumference [knee circumference 1cm above patella (1 cm KC) and 10cm above patella (10 cm KC)] and thigh volume (TV) were measured at 4 weeks before operation, 1 day before operation and after operation, and the levels of serum superoxide dismutase (SOD), malondialdehyde (MDA), tumor necrosis factor α(TNF-α) and interleukin -1β(IL-1β) were observed. 【Results】 The QST and SOD of the two groups was significantly lower than that at 4 weeks and 1 day before operation (P<0.05), and the above indexes in the LST group were lower than those in the control group (P<0.05). After operation, 1 cm KC, 10 cm KC, TV, TNF-α, IL-1β and MDA, in the two groups were significantly higher than those at 4 weeks and 1 day before operation (P<0.05), and the above indexes in the LST group were lower than those in the control group (P<0.05). VAS during QST, VAS, during stand up and walk time test, stand up and walk time test in the two groups were significantly higher than those at 4 weeks and 1 day before operation (P<0.05), and the above indexes in the LST group were lower than those in the control group (P<0.05). 【Conclusion】 LST can improve the strength of quadriceps femoris, reduce the swelling of knee and thigh and reduce the degree of pain in patients with TKA.
付晓伟, 邵正海, 许彩霞, 刘芩, 刘杰. 术前低强度慢动作训练对膝骨性关节炎患者全膝关节置换术后早期股四头肌肌力的影响[J]. 医学临床研究, 2021, 38(12): 1822-1825.
FU Xiao-wei, SHAO Zheng-hai, XU Cai-xia, et al. Effect of Preoperative Low Intensity Slow Motion Training on Quadriceps Femoris Muscle Strength in Patients with Knee Osteoarthritis after Total Knee Arthroplasty. JOURNAL OF CLINICAL RESEARCH, 2021, 38(12): 1822-1825.
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