本体感觉神经肌肉促进技术对老年膝骨关节炎患者步行时关节负荷效果的随机对照试验

doi:10.3969/j.issn.1006-9771.2024.07.015

《中国康复理论与实践》 ›› 2024, Vol. 30 ›› Issue (7): 854-860.doi: 10.3969/j.issn.1006-9771.2024.07.015

本体感觉神经肌肉促进技术对老年膝骨关节炎患者步行时关节负荷效果的随机对照试验

沈培鑫¹, 罗心², 车欣恒², 刘延浩², 毛德伟¹, 宋祺鹏¹()

1.山东体育学院运动与健康学院，山东济南市 250102
2.山东体育学院研究生教育学院，山东济南市 250102

收稿日期:2023-12-19 修回日期:2024-05-28 出版日期:2024-07-25 发布日期:2024-08-07
通讯作者: 宋祺鹏(1982-)，男，汉族，山东泰安市人，博士，教授，主要研究方向：运动生物力学，E-mail： songqipeng@163.com
作者简介:沈培鑫(1993-)，女，汉族，福建漳州市人，博士，副教授，主要研究方向：运动康复与运动生物力学；
罗心(1999-)，男，汉族，湖南益阳市人，硕士研究生，主要研究方向：运动康复。
基金资助:
国家自然科学基金青年项目(12102235);国家体育总局青年项目(23QN009)

Effect of proprioceptive neuromuscular facilitation on knee loading during walking for old knee osteoarthritis patients: a randomized controlled trial

SHEN Peixin¹, LUO Xin², CHE Xinheng², LIU Yanhao², MAO Dewei¹, SONG Qipeng¹()

1. College of Sports and Health, Shandong Sport University, Ji'nan, Shandong 250102, China
2. College of Graduate Education, Shandong Sport University, Ji'nan, Shandong 250102, China

Received:2023-12-19 Revised:2024-05-28 Published:2024-07-25 Online:2024-08-07
Contact: SONG Qipeng, E-mail: songqipeng@163.com
Supported by:
National Natural Science Foundation of China (Youth)(12102235);General Administration of Sport of China Program (Youth)(23QN009)

摘要/Abstract

摘要：

目的探究本体感觉神经肌肉促进技术(PNF)对膝内侧间室骨关节炎老年患者步行时膝外展力矩和股内侧肌-内侧腓肠肌(VM-MG)共激活指数的影响。
方法 2022年3月至5月，在济南社区招募膝骨关节炎老年患者32例，随机分为对照组(n = 16)和训练组(n = 16)。训练组接受PNF治疗，对照组自行居家运动，共6周。治疗前后采用红外运动捕捉系统同步三维测力台和肌电图系统测量患者平地步行时的膝外展力矩和肌肉共激活指数。
结果对照组3例脱落，训练组2例脱落。治疗后，训练组膝外展力矩第一峰值、第二峰值和VM-MG共激活指数均较治疗前改善(|t| > 2.460, P < 0.05)，且训练组膝外展力矩第一峰值、第二峰值均较对照组改善(|t| > 2.454, P < 0.05)。
结论 PNF有助于促进膝骨关节炎患者膝关节内外间室负荷的均匀分布。

关键词: 膝骨关节炎, 本体感觉神经肌肉促进技术, 关节力矩, 共激活, 步行

Abstract:

Objective To explore the effect of proprioceptive neuromuscular facilitation (PNF) on the knee abduction torque and vastus medialis-medial gastrocnemius (VM-MG) co-contraction index during walking among the old patients with medial compartment knee osteoarthritis.
Methods From March to May, 2022, 32 old patients with medial compartment knee osteoarthritis in communities in Ji'nan were enrolled and randomly allocated to control group (n = 16) and training group (n = 16). The training group received PNF and the control group received home-based exercise, for six weeks. The knee abduction torque and VM-MG co-contraction index were measured using an infrared motion capture system synchronized with 3D force plate and electromyography system before and after treatment.
Results Three cases in the control group and two cases in the training group dropped off. The first and the second peaks of knee abduction torque, and the VM-MG co-contraction index improved in the training group after treatment (|t| > 2.460, P < 0.05), and the first and the second peaks of knee abduction torque were better in the training group than in the control group (|t| > 2.454, P < 0.05).
Conclusion PNF may optimize the load distribution between the medial and lateral compartments of the knee in patients with knee osteoarthritis.

Key words: knee osteoarthritis, proprioceptive neuromuscular facilitation, joint torque, co-contraction, walking

中图分类号:

R684.3

沈培鑫, 罗心, 车欣恒, 刘延浩, 毛德伟, 宋祺鹏. 本体感觉神经肌肉促进技术对老年膝骨关节炎患者步行时关节负荷效果的随机对照试验[J]. 《中国康复理论与实践》, 2024, 30(7): 854-860.

SHEN Peixin, LUO Xin, CHE Xinheng, LIU Yanhao, MAO Dewei, SONG Qipeng. Effect of proprioceptive neuromuscular facilitation on knee loading during walking for old knee osteoarthritis patients: a randomized controlled trial[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(7): 854-860.

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组别	n	性别(男/女)/n	患侧(单/双)/n	K/L分级(I/II/III)/n	年龄/岁	身高/cm	体质量/kg	BMI/(kg·m^-2)	步速/(m·s^-1)
对照组	13	3/10	10/3	4/6/3	66.4±2.4	162.7±4.6	71.5±7.8	27.0±3.3	1.03±0.10
训练组	14	4/10	10/4	4/7/3	65.3±4.6	162.4±7.5	70.3±6.0	26.7±2.5	1.06±0.11
χ²/t值		0.106	0.106	0.040	1.327	-0.146	-0.433	-0.279	0.799
P值		0.745	0.746	0.980	0.196	0.885	0.662	0.782	0.432

变量	组别	n	测试	$\bar{x}±s$	t值	P值
第一峰值	对照组	13	前测	0.42±0.18	-0.672	0.514
			后测	0.45±0.16
	训练组	14	前测	0.38±0.10	2.664	0.019
			后测	0.30±0.15
	治疗前两组均值差			-0.03±0.20	-0.719	0.479
	治疗后两组均值差			-0.14±0.19	-2.454	0.021
第二峰值	对照组	13	前测	0.32±0.12	-0.843	0.415
			后测	0.36±0.18
	训练组	14	前测	0.28±0.12	2.908	0.012
			后测	0.21±0.08
	治疗前两组均值差			-0.03±0.17	-0.776	0.445
	治疗后两组均值差			-0.15±0.22	-2.861	0.008

组别	n	测试	$\bar{x}±s$	t值	P值
对照组	13	前测	54.63±19.46	-1.403	0.186
		后测	60.75±16.61
训练组	14	前测	62.08±16.65	2.460	0.029
		后测	52.96±14.79
治疗前两组均值差			6.35±23.84	1.224	0.232
治疗后两组均值差			-7.32±33.68	-1.115	0.275

本体感觉神经肌肉促进技术对老年膝骨关节炎患者步行时关节负荷效果的随机对照试验

Effect of proprioceptive neuromuscular facilitation on knee loading during walking for old knee osteoarthritis patients: a randomized controlled trial

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