《中国康复理论与实践》

《中国康复理论与实践》 ›› 2009, Vol. 15 ›› Issue (06): 508-513.

• 专题 • 上一篇    下一篇

膝骨关节炎患者与正常人股内侧肌、股直肌和股外侧肌收缩特征的对照研究

师东良;王宁华;谢斌   

  1. 北京大学第一医院物理医学与康复科，北京市 100034
  • 收稿日期:2009-06-08 出版日期:2009-06-01 发布日期:2009-06-01
  • 通讯作者: 王宁华

Activation Characteristics of Vastus Medialis, Rectus Femoris and Vastus Lateralis Muscles in Patients with Knee Osteoarthritis and Health Subjects

SHI Dong-liang，WANG Ning-hua，XIE Bin   

  1. Peking University First Hospital，Beijing 100034,Beijing,China
  • Received:2009-06-08 Published:2009-06-01 Online:2009-06-01

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被引次数

55

摘要： 目的 应用表面肌电图和等速肌力评测方法比较膝骨关节炎患者与正常人股内侧肌、股直肌、股外侧肌肌肉收缩特征，包括收缩速度、收缩力量和抗疲劳性。方法 34例膝骨关节炎患者参与观察组；34名健康人参与对照组。两组的年龄、身高、体重、性别、左右侧、Q角相匹配。所有受试者均在膝关节屈曲10°、60°、100°等长伸膝和等速60°/s、180°/s伸膝运动测试模式下，进行股内侧肌、股直肌和股外侧肌的表面肌电图和股四头肌肌力的评测。采用独立样本t检验对两组评定指标包括募集速率、平均振幅、峰力矩/体重比、疲劳指数分别进行对比分析。结果 ①观察组股内侧肌在膝屈60°等长伸膝测试和等速60°/s、180°/s伸膝测试中募集速率较对照组减小；股直肌在膝屈60°等长伸膝测试和等速60°/s伸膝测试中募集速率较对照组减小；股外侧肌在等长膝屈10°和100°伸膝测试和等速60°/s伸膝测试中募集速率较对照组减小（P＜0.05）。②观察组股内侧肌、股直肌在等速60°/s、180°/s伸膝测试中平均振幅较对照组增大；观察组股直肌、股外侧肌在等长膝屈10°伸膝测试中平均振幅较对照组增大（P＜0.05）。③观察组股内侧肌、股直肌和股外侧肌在膝屈10°、60°、100°等长伸膝和等速60°/s、180°/s伸膝运动测试模式中峰力矩/体重比均小于对照组（P＜0.05）。④观察组在等速180°/s伸膝测试中股四头肌耐疲劳能力较对照组增强（P＜0.05）。结论 膝骨关节炎患者患侧股内侧肌、股直肌和股外侧肌的收缩速度减慢、收缩力量减小、抗疲劳性增加。

关键词: 膝骨关节炎, 股四头肌, 表面肌电图, 等速肌力

Abstract: Objective To investigate the activation characteristics (contraction velocity, force and anti-fatigue) of the vastus medialis (VM), rectus femoris (RF) and vastus lateralis (VL) by using surface electromyogram (sEMG) during isometric and isokinetic quadriceps femoris force tests in knee osteoarthritis. Methods The participants included an observation group (n=34) and a control group (n=34).The age, height, body weight, gender, dominant side and Q angle were matched between the two groups. The participants' quadriceps femoris force and sEMG of VM, RF and VL were tested in isometric knee extension at knee joint angles of 10°, 60°, 100° and isokinetic knee extension at velocities of 60°/s and 180°/s. Comparisons were made for recruitment rate, average amplitude, peak torque/bodyweight ratio, index of fatigue by independent-group t-test, with the alpha level set at 0.05 for significant differences between groups.Results ①Recruitment rate of VM in isometric contraction at 60° and isokinetic contraction at 60°/s and 180°/s, RF in isometric contraction at 60° and isokinetic contraction at 60°/s and VL in isometric contraction at 10°and 100° and isokinetic contraction at 60°/s were all significantly slower in the observation group than that in the control group(P<0.05). ②The average amplitudes of VM, RF in isokinetic contraction at 60°/s and 180°/s and RF, VL in isometric contraction at 10° were significantly higher in the observation group than that in the control group(P<0.05). ③Peak torque/bodyweight ratio of quadriceps was significantly lower in the observation group than that in the control group in isometric contraction at 10°, 60°, 100° and isokinetic contraction at 60°/s and 180°/s(P<0.05). ④In isokinetic contraction at 180°/s the index of fatigue was significantly higher in the observation group than that in the control group (P<0.05).Conclusion A significant decreasing contraction velocity and force, increasing anti-fatigue of the vastus medialis, rectus femoris and vastus lateralis were found in knee osteoarthritis patients when compared with healthy subjects.

Key words: knee osteoarthritis, quadriceps femoris, sEMG, isokinetic force