不同频率振动训练对膝骨关节炎老年人下肢肌力和症状的影响

doi:10.3969/j.issn.1006-9771.2020.08.014

摘要/Abstract

摘要：

目的探讨不同频率振动训练对膝骨关节炎(KOA)老年人下肢关节肌力和症状的影响。方法 2019年7月至10月,82例KOA老年人随机分成对照组(n = 20)、低频组(n = 20)、中频组(n = 21)和高频组(n = 21)。低频组、中频组和高频组进行振幅3 mm,频率分别为15 Hz、30 Hz和45 Hz的振动训练,每次15 min,每周3次,共16周。训练前后进行双侧下肢关节屈伸等速肌力测试,角速度为60°/s和180°/s;采用西安大略和麦克马斯特大学骨关节炎指数(WOMAC)进行评定。结果训练后,中频组60°/s和180°/s下膝关节伸肌峰力矩均增加(|t| > 2.162, P < 0.05),高频组膝和踝关节伸肌峰力矩均增加(| t| > 2.227, P < 0.05);高频组髋和膝关节伸肌耐力均增加(| t| > 1.997, P < 0.05),WOMAC疼痛得分显著减少( t = 16.901, P < 0.001)。训练后,高频组60°/s下膝和踝关节伸肌峰力矩,髋和膝关节伸肌耐力值大于低频组和中频组( P< 0.05);高频组180°/s下髋、膝和踝关节伸肌峰力矩大于低频组(P< 0.05);高频组WOMAC疼痛得分小于其他三组(P< 0.05)。结论 45 Hz振动训练能提高KOA老年人膝和踝关节伸肌绝对力和爆发力,髋和膝关节伸肌耐力,减轻疼痛症状。

关键词: 振动训练, 膝关节骨性关节炎, 老年人, 肌力, 症状

Abstract:

Objective To explore the effect of vibration training with different frequencies on muscle strength and symptoms of lower limb joints in the elderly suffering from knee osteoarthritis (KOA). Methods From July to October, 2019, 82 KOA elderly were randomly divided into control group (n = 20), low frequency group (n = 20), medium frequency group (n = 21) and high frequency group (n = 21). The latter three groups received 15 Hz, 30 Hz and 45 Hz vibration training, respectively, with the same amplitude (3 mm), 15 minutes a time, three times a week, for 16 weeks. The flexion and extension isokinetic muscle strength (60°/s and 180°/s) of lower limb joints were tested, and they were assessed with Western Ontario and McMaster Universities Osteoarthritis Index before and after training.Results After training, the peak torques of knee extensor under 60°/s and 180°/s increased in the medium frequency group (|t| > 2.162, P <0.05), the peak torques of knee and ankle extensors under 60°/s and 180°/s increased in the high frequency group (| t| > 2.227, P <0.05), the endurance of hip and knee extensors increased (| t| > 1.997, P < 0.05), and the score of pain significantly decreased ( t = 16.901, P < 0.001) in the high frequency group. After training, the peak torques of knee and ankle extensors under 60°/s, the endurance of hip and knee extensors were higher in the high frequency group than in the low frequency group and the medium frequency group ( P< 0.05); the peak torques of hip, knee and ankle extensors under 180°/s were higher in the high frequency group than in the low frequency group (P< 0.05); the score of pain was lower in the high frequency group than in other groups (P< 0.05).Conclusion 45 Hz vibration training could improve the absolute force and explosive force of knee and ankle extensors, and the endurance of hip and knee extensors; and relieve pain in KOA elderly.

Key words: vibration training, knee osteoarthritis, aged, muscle strength, symptoms

中图分类号:

R684.3

刘衡,叶姝. 不同频率振动训练对膝骨关节炎老年人下肢肌力和症状的影响[J]. 《中国康复理论与实践》, 2020, 26(8): 947-954.

LIU Heng,YE Shu. Effect of Vibration Training with Different Frequencies on Lower Limb Muscle Strength and Symptoms of Knee Osteoarthritis in Old Adults[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(8): 947-954.

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组别	n	性别(男/女,n)	年龄(岁)	身高(cm)	体质量(kg)
对照组	20	5/15	64.3±1.9	169.9±5.9	66.0±6.2
低频组	20	4/16	63.7±2.3	169.1±3.4	66.1±5.8
中频组	21	5/16	64.0±2.2	169.7±3.9	66.3±6.0
高频组	21	6/15	63.8±2.8	169.4±4.5	65.8±4.9
χ²/F值		0.456	0.662	0.398	0.502
P值		0.801	0.638	0.871	0.763

时间	组别	n	屈			伸
时间	组别	n	髋	膝	踝	髋	膝	踝
训练前	对照组	20	80.6±17.8	28.2±14.6	15.1±1.4	93.2±17.2	48.5±9.0	20.8±5.8
	低频组	20	78.5±16.6	30.5±13.5	13.9±3.1	94.3±16.7	47.3±16.2	19.9±8.5
	中频组	21	79.3±13.2	28.7±12.6	15.0±3.7	92.0±17.0	48.6±19.4	20.7±3.8
	高频组	21	77.0±13.2	30.1±9.8	14.5±2.5	91.0±18.6	47.8±12.9	19.3±5.2
训练后	对照组	20	82.4±13.7	29.6±8.3	14.7±2.8	92.6±17.5	47.1±12.7	19.6±3.9
	低频组	20	80.4±15.0	29.2±9.6	14.8±2.2	95.6±20.2	46.6±18.9^g	20.6±5.3^g
	中频组	21	81.5±15.6	28.7±15.2	14.7±2.6	96.6±15.0	53.6±16.0^h,i	21.0±4.8^h,i
	高频组	21	88.1±10.1	30.5±11.2	15.9±1.8	94.3±21.7	55.2±17.1^h,j,k	23.0±3.5^h,j,k
	t值^a		0.621	-0.058	-0.457	-0.063	1.335	-1.525
	P值^a		0.546	0.935	0.651	0.951	0.205	0.106
	t值^b		-1.444	1.307	-0.450	-0.318	0.626	1.301
	P值^b		0.172	0.216	0.660	0.752	0.543	0.219
	t值^c		-1.342	-0.415	-1.385	0.060	-2.162	-1.530
	P值^c		0.203	0.686	0.189	0.958	0.042	0.154
	t值^d		1.534	-0.630	-0.19	-1.104	-2.227	2.465
	P值^d		0.151	0.541	0.549	0.290	0.040	0.038
	F值^e		0.072	0.590	0.510	1.842	1.317	0.451
	P值^e		0.995	0.709	0.760	0.113	0.261	0.812
	F值^f		0.780	0.466	0.066	1.790	2.094	2.165
	P值^f		0.565	0.799	0.996	0.126	0.040	0.036

时间	组别	n	屈			伸
时间	组别	n	髋	膝	踝	髋	膝	踝
训练前	对照组	20	70.5±10.9	26.3±10.7	12.6±4.5	85.5±17.7	46.2±19.8	17.6±3.2
	低频组	20	69.2±9.0	26.6±7.2	12.2±2.8	86.2±26.0	47.5±12.3	16.5±2.4
	中频组	21	67.6±11.1	27.3±7.0	12.3±3.1	85.2±25.3	48.2±10.5	17.4±4.5
	高频组	21	71.3±12.4	27.7±9.6	13.0±2.4	87.0±24.0	46.0±10.0	16.9±2.2
训练后	对照组	20	69.0±17.2	27.6±9.2	11.9±3.8	84.4±19.6	50.5±16.5	18.1±4.4
	低频组	20	68.0±10.9	27.5±10.5	12.8±4.5	88.0±21.6^g	49.0±9.0^g	14.9±1.6^g
	中频组	21	70.0±15.2	28.0±6.0	12.6±4.2	87.5±27.6^g,i	54.3±15.4^g,i	18.6±3.5^g,i
	高频组	21	70.6±13.5	27.8±11.3	13.4±5.1	92.0±28.3^h,j	56.0±7.6^h,j	20.6±6.2^h,j
	t值^a		-1.350	-0.072	0.068	-1.389	0.078	0.051
	P值^a		0.456	0.944	0.951	0.176	0.937	0.983
	t值^b		-0.061	-1.222	-0.450	-1.441	0.630	-0.036
	P值^b		0.956	0.211	0.657	0.173	0.541	0.995
	t值^c		0.619	-0.058	-0.629	0.992	2.230	-0.311
	P值^c		0.549	0.962	0.541	0.332	0.039	0.762
	t值^d		-0.362	-1.001	-0.060	-0.787	12.775	12.995
	P值^d		0.722	0.299	0.958	0.436	0.007	0.005
	F值^e		0.460	0.431	0.781	0.660	0.390	0.501
	P值^e		0.806	0.797	0.566	0.640	0.875	0.765
	F值^f		1.422	0.070	0.510	1.998	2.660	2.829
	P值^f		0.201	0.996	0.761	0.045	0.017	0.013

时间	组别	n	屈			伸
时间	组别	n	髋	膝	踝	髋	膝	踝
训练前	对照组	20	0.87±0.10	0.79±0.05	0.92±0.06	0.81±0.08	0.65±0.03	0.61±0.10
	低频组	20	0.87±0.10	0.78±0.06	0.92±0.08	0.81±0.05	0.65±0.08	0.62±0.03
	中频组	21	0.86±0.06	0.78±0.12	0.93±0.05	0.80±0.07	0.66±0.07	0.63±0.06
	高频组	21	0.88±0.06	0.77±0.06	0.90±0.06	0.80±0.05	0.65±0.04	0.62±0.07
训练后	对照组	20	0.86±0.11	0.78±0.04	0.93±0.06	0.80±0.11	0.66±0.05	0.60±0.07
	低频组	20	0.86±0.09	0.79±0.07	0.94±0.10	0.81±0.07^g	0.66±0.04^g	0.63±0.05
	中频组	21	0.87±0.08	0.77±0.09	0.94±0.08	0.81±0.06^g	0.68±0.09^g	0.64±0.09
	高频组	21	0.87±0.09	0.79±0.08	0.94±0.10	0.86±0.06^h,i,j	0.72±0.11^h,i,j	0.64±0.03
	t值^a		-1.226	-1.102	-0.707	-0.352	1.507	0.080
	P值^a		0.208	0.293	0.492	0.730	0.153	0.935
	t值^b		0.452	-0.360	0.065	0.705	1.512	1.100
	P值^b		0.654	0.724	0.949	0.493	0.151	0.293
	t值^c		1.337	-1.535	-0.032	-0.074	-1.302	0.620
	P值^c		0.203	0.149	0.968	0.942	0.219	0.548
	t值^d		-0.626	-0.319	0.028	-1.997	2.007	1.308
	P值^d		0.543	0.755	0.973	0.049	0.046	0.215
	F值^e		1.426	1.796	0.066	1.865	0.410	0.588
	P值^e		0.235	0.123	0.996	0.107	0.865	0.713
	F值^f		0.788	0.660	0.392	2.126	2.195	0.501
	P值^f		0.547	0.640	0.873	0.040	0.042	0.765

时间	组别	疼痛	僵硬	身体功能
训练前	对照组	6.5±1.3	3.2±1.0	10.4±2.4
	低频组	6.5±1.2	3.2±1.1	10.6±3.0
	中频组	6.3±1.9	3.3±0.9	10.3±1.9
	高频组	6.4±1.6	3.3±0.7	10.5±2.6
训练后	对照组	6.3±1.6	3.0±0.8	10.5±3.2
	低频组	6.6±1.4^g	3.1±0.8	10.2±2.7
	中频组	6.2±2.2^g	3.2±1.6	10.0±2.8
	高频组	5.2±1.3^h,i,j	3.2±1.4	10.0±3.7
	t值^a	-0.080	-0.046	-0.042
	P值^a	0.935	0.987	0.993
	t值^b	-0.075	0.363	-0.703
	P值^b	0.940	0.721	0.496
	t值^c	-0.316	0.072	0.423
	P值^c	0.758	0.944	0.679
	t值^d	16.901	-0.069	-0.418
	P值^d	< 0.001	0.952	0.682
	F值^e	1.811	0.389	0.392
	P值^e	0.121	0.876	0.871
	F值^f	9.826	0.662	0.509
	P值^f	< 0.001	0.638	0.115