《中国康复理论与实践》

《中国康复理论与实践》 ›› 2023, Vol. 29 ›› Issue (8): 882-889.doi: 10.3969/j.issn.1006-9771.2023.08.003

• 专题 运动和平衡功能康复 • 上一篇    下一篇

核心稳定性训练干预前交叉韧带重建术后动态平衡及表面肌电的效果

马圣楠1,2, 柯竟悦1, 董洪铭1, 李建萍1, 张洪浩1, 刘超1, 沈双3, 李古强3()   

  1. 1.滨州医学院康复医学院，山东烟台市 264003
    2.滨州医学院烟台附属医院，山东烟台市 264003
    3.滨州医学院康复工程研究院，山东烟台市 264003
  • 收稿日期:2023-03-09 修回日期:2023-05-22 出版日期:2023-08-25 发布日期:2023-10-09
  • 通讯作者: 李古强 E-mail:lgq100@bzmc.edu.cn
  • 作者简介:马圣楠(1996-)，女，汉族，江苏徐州市人，硕士研究生，主要研究方向：运动康复及生物力学分析。
  • 基金资助:
    山东省自然科学基金面上项目(ZR2022MA047);2021年山东省本科教学改革研究面上项目(M2021213)

Effect of core stability training on dynamic balance and surface electromyography after anterior cruciate ligament reconstruction

MA Shengnan1,2, KE Jingyue1, DONG Hongming1, LI Jianping1, ZHANG Honghao1, LIU Chao1, SHEN Shuang3, LI Guqiang3()   

  1. 1. School of Rehabilitation, Binzhou Medical University, Yantai, Shandong 264003, China
    2. Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264003, China
    3. Rehabilitation Engineering Research Institute of Binzhou Medical University, Yantai, Shandong 264003, China
  • Received:2023-03-09 Revised:2023-05-22 Published:2023-08-25 Online:2023-10-09
  • Contact: LI Guqiang E-mail:lgq100@bzmc.edu.cn
  • Supported by:
    Shandong Natural Science Foundation(ZR2022MA047);2021 Undergraduate Teaching Reform Research Project of Shandong Province(M2021213)

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摘要：

目的 观察核心稳定性训练对前交叉韧带重建术后动态平衡和表面肌电的效果，分析动态平衡指标与表面肌电的相关性。
方法 2022年3月至12月，滨州医学院烟台附属医院前交叉韧带重建术患者32例随机分为对照组(n = 16)和试验组(n = 16)。对照组给予常规康复训练，试验组在此基础上增加核心稳定性训练，共6周。于治疗前后分别进行美国特种外科医院膝关节评分(HSS)和国际膝关节评分委员会膝关节主观评价表(IKDC)、动态平衡功能和表面肌电评定，并对表面肌电均方根值(RMS)与动态平衡指标进行相关性分析。
结果 干预后，两组HSS和IKDC评分均显著增加(|Z| > 3.526, |t| > 63.544, P < 0.001)，试验组优于对照组(Z = -2.392, t = 2.650, P < 0.05);两组步态线长度、单支撑线长度均增加，内外侧位移减小(|t| > 2.368, Z = -3.516, P < 0.05)，试验组优于对照组(|t| > 2.497, Z = -3.091, P < 0.05);试验组臀大肌和臀中肌RMS明显增加(t = -5.900, Z = -2.741, P < 0.01)，试验组明显优于对照组(t = 3.930, Z = -3.260, P < 0.01)。干预后所有患者臀大肌、臀中肌RMS与步态线长度、单支撑线长度呈正相关，与内外侧位移呈负相关(|r| > 0.502, P < 0.01)。
结论 核心稳定性训练可显著改善膝关节功能和动态平衡，增强臀大肌和臀中肌的激活程度，且动态平衡与表面肌电具有高度相关性。

关键词: 前交叉韧带重建术, 核心稳定性训练, 动态平衡, 足, 压力中心, 表面肌电

Abstract:

Objective To explore the effect of core stability training on dynamic balance and surface electromyography (sEMG) after anterior cruciate ligament reconstruction (ACLR), and to analyze the correlation between balance index and sEMG.
Methods From March to December, 2022, 32 patients with ACLR in Yantai Affiliated Hospital of Binzhou Medical University were randomly divided into control group (n = 16) and experimental group (n = 16). The control group accepted routine rehabilitation treatment, and the experimental group added core stability training, for six weeks. They were evaluated with American Hospital for Special Surgery Knee Score (HSS) and International Knee Documentation Committee Knee Score (IKDC), and the dynamic balance function and sEMG were measured before and after treatment, and the correlation between dynamic balance index and root mean square (RMS) of sEMG was analyzed.
Results After treatment, the scores of HSS and IKDC increased significantly in both groups (|Z| > 3.526, |t| > 63.544, P < 0.001), and were better in the experimental group than in the control group (Z = -2.392, t = 2.650, P < 0.05); the length of gait line and single support line increased significantly, the medial-lateral displacement displacement decreased (|t| > 2.368, Z = -3.516, P < 0.05), and they were better in the experimental group than in the control group (|t| > 2.497, Z = -3.091, P < 0.05); the RMS of gluteus maximus and gluteus medius increased in the experimental group (t = -5.900, Z = -2.741, P < 0.01), and were better than those in the control group (t = 3.930, Z = -3.260, P < 0.01). After treatment, the RMS of gluteus maximus and gluteus medius in both groups were positively correlated with gait line length and single support line length, and were negatively correlated with medial-lateral displacement (|r| > 0.502, P < 0.01).
Conclusion Core stability training could significantly improve knee joint function and dynamic balance, and enhance the activation of gluteus maximus and gluteus medius. Dynamic balance is highly correlated with sEMG.

Key words: anterior cruciate ligament reconstruction, core stability training, dynamic balance, foot, center of pressure, surface electromyography

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