不同强度神经肌肉功能训练对前交叉韧带重建术后患者肌力和膝关节功能的影响

doi:10.3969/j.issn.1006-9771.2025.09.012

《中国康复理论与实践》 ›› 2025, Vol. 31 ›› Issue (9): 1083-1091.doi: 10.3969/j.issn.1006-9771.2025.09.012

不同强度神经肌肉功能训练对前交叉韧带重建术后患者肌力和膝关节功能的影响

汪娟¹^,², 张庆³, 周长林¹^,², 陈长运¹^,², 戴峰¹^,², 孙像鸿¹^,², 邹婷¹^,², 王健¹^,², 高骏凯¹^,², 徐卫东³()

¹ 苏州大学附属常州老年病医院康复医学科，江苏常州市 213011
² 常州市第七人民医院康复医学科，江苏常州市 213011
³ 第二军医大学附属医院长海医院骨科，上海市 200433

收稿日期:2025-06-09 修回日期:2025-09-07 出版日期:2025-09-25 发布日期:2025-10-10
通讯作者: 徐卫东，男，博士，教授，主任医师，主要研究方向：骨外科学、运动医学，E-mail： xuwdshanghai@126.com。
作者简介:汪娟(1994-)，女，汉族，安徽安庆市人，硕士研究生，主管治疗师，主要研究方向：慢性疼痛、运动损伤康复。
基金资助:
1.常州市卫健委重大科技项目(ZD202228);2.常州市卫生健康青苗人才培养资助项目(CZQM2023024);3.常州市"龙城医星"卫生青年科技人才托举工程项目(lcyx202309)

Effect of different intensity neuromuscular training on muscle strength and knee joint function of patients after anterior cruciate ligament reconstruction

WANG Juan¹^,², ZHANG Qing³, ZHOU Changlin¹^,², CHEN Changyun¹^,², DAI Feng¹^,², SUN Xianghong¹^,², ZOU Ting¹^,², WANG Jian¹^,², GAO Junkai¹^,², XU Weidong³()

¹ Department of Rehabilitation Medicine, Changzhou Geriatric Hospital Affiliated to Soochow University, Changzhou, Jiangsu 213011, China
² Department of Rehabilitation Medicine, Changzhou No. 7 People's Hospital, Changzhou, Jiangsu 213011, China
³ Department of Orthopedics, Changhai Hospital, Second Military Medical University, Shanghai 200433, China

Received:2025-06-09 Revised:2025-09-07 Published:2025-09-25 Online:2025-10-10
Contact: XU Weidong, E-mail: xuwdshanghai@126.com
Supported by:
Major Science and Technology Project of Changzhou Health Commission(ZD202228);Young Talent Development Plan of Changzhou Health Commission(CZQM2023024);Changzhou "Longcheng Medical Star" Health Young Science and Technology Talent Lifting Project(lcyx202309)

摘要/Abstract

摘要：

目的对比不同强度神经肌肉功能训练(NMT)对前交叉韧带重建术(ACLR)后患者肌力和功能的影响。

方法 2023年1月至2024年1月，选择长海医院ACLR患者60例，均于术后1~8周接受统一强度的NMT，术后8周，随机分为低强度组(n = 30)和高强度组(n = 30)。术后9~16周分别接受不同强度的NMT，单次训练1 h，每周3次，共计48次。分别在术后8周和16周，比较Lysholm评分，患侧膝关节屈肌、伸肌肌力和肌肉耐力。

结果分组训练后，两组Lysholm评分均显著增加(|t| > 13.739, P < 0.001)，且高强度组高于低强度组(t = -2.574, P < 0.05)；高强度组在60°/s、120°/s和180°/s的角速度下伸肌和屈肌相对峰力矩、肌耐力均改善(|t| > 2.320, P < 0.05)，低强度组屈肌相对峰力矩在3种角速度下均改善(t > 2.177, P < 0.05)，伸肌相对峰力矩在60°/s和180°/s的角速度下均改善(|t| > 1.715, P < 0.05)，伸肌耐力在60°/s角速度下改善(t = -2.293, P < 0.05)；但两组间比较，伸肌和屈肌相对峰力矩、肌耐力在60°/s、120°/s和180°/s的角速度下均无显著性差异(P > 0.05)。

结论高、低强度NMT均可以改善ACLR患者肌力、肌耐力和膝关节功能，高强度NMT可能优于低强度，还需进一步验证。

关键词: 前交叉韧带, 神经肌肉功能训练, 肌力, 肌耐力, 功能

Abstract:

Objective To compare the effect of different intensity of neuromuscular training (NMT) on muscle strength and knee joint function of patients after anterior cruciate ligament reconstruction (ACLR).

Methods From January, 2023 to January, 2024, 60 ACLR patients in Changhai Hospital were selected, and they received the same intensity of NMT from one to eight weeks after surgery. Eight weeks after surgery, they were randomly divided into low intensity group (n = 30) and high intensity group (n = 30), and then they received different intensities of NMT from nine to 16 weeks after surgery, each training session lasted one hour, with three sessions per week, totaly 48 sessions. The Lysholm score, knee flexor and extensor muscle strength and muscle endurancewere compared at eight weeks and 16 weeks after surgery.

Results After group training, the Lysholm score significantly increased in both groups (|t| > 13.739, P <0.001), and was higher in the high intensity group than in the low intensity group (t = -2.574, P < 0.05); in the high intensity group, the relative peak torque and endurance of the extensor and flexor muscles improved at angular velocities of 60°/s, 120°/s and 180 °/s (|t| > 2.320, P <0.05); in the low intensity group, the flexor peak torque improved at all the three angular velocities (t > 2.177, P< 0.05), the extensor peak torque improved at angular velocities of 60°/s and 180°/s (|t| > 1.715, P <0.05), and the extensor endurance improved at angular velocity of 60°/s (t = -2.293, P < 0.05). However, there was no significant difference in the relative peak torque and endurance of the extensor and flexor muscles at all the three angular velocities (P > 0.05).

Conclusion Both high and low intensity NMT could improve the muscle strength, muscle endurance and knee joint function. Maybe, high intensity is superior to low intensity. Further verification is still needed.

Key words: anterior cruciate ligament, neuromuscular training, muscle strength, muscle endurance, function

中图分类号:

R686.5

汪娟, 张庆, 周长林, 陈长运, 戴峰, 孙像鸿, 邹婷, 王健, 高骏凯, 徐卫东. 不同强度神经肌肉功能训练对前交叉韧带重建术后患者肌力和膝关节功能的影响[J]. 《中国康复理论与实践》, 2025, 31(9): 1083-1091.

WANG Juan, ZHANG Qing, ZHOU Changlin, CHEN Changyun, DAI Feng, SUN Xianghong, ZOU Ting, WANG Jian, GAO Junkai, XU Weidong. Effect of different intensity neuromuscular training on muscle strength and knee joint function of patients after anterior cruciate ligament reconstruction[J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(9): 1083-1091.

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组别	n	性别(男/女)/n	年龄/岁	身高/m	体质量/kg	BMI/(kg⋅m^-2)	患病部位(左/右)/n
低强度组	30	18/12	31.03±6.33	1.76±0.16	71.30±13.03	23.58±5.53	13/17
高强度组	30	17/13	31.43±6.54	1.75±0.08	71.88±12.34	23.49±3.19	14/16
χ²/t值		0.069	-0.241	0.278	-0.176	0.073	0.067
P值		0.793	0.811	0.782	0.861	0.942	0.795

组别	n	测试	$\stackrel{-}{x}\pm s$	t值	P值
低强度组	30	前测	64.73±9.25	-13.739	< 0.001
		后测	89.33±4.08
高强度组	30	前测	65.30±8.26	-14.929	< 0.001
		后测	92.20±4.54
分组训练前两组均值差			0.57±13.74	-0.250	0.803
分组训练后两组均值差			2.87±6.05	-2.574	0.013

变量	组别	n	测试	$\stackrel{-}{x}\pm s$	t值	P值
伸肌相对峰力矩/(N⋅m⋅kg^-1)	低强度组	30	前测	0.74±0.35	-3.408	0.002
			后测	0.90±0.29
	高强度组	30	前测	0.79±0.28	-3.814	0.001
			后测	1.00±0.23
	分组训练前两组均值差			0.05±0.46	-0.613	0.543
	分组训练后两组均值差			0.10±0.41	-1.532	0.131
屈肌相对峰力矩/(N⋅m⋅kg^-1)	低强度组	30	前测	-0.56±0.22	-2.194	0.036
			后测	-0.66±0.31
	高强度组	30	前测	-0.50±0.16	4.379	< 0.001
			后测	-0.57±0.14
	分组训练前两组均值差			0.06±0.29	-1.184	0.242
	分组训练后两组均值差			0.09±0.38	-1.443	0.157
伸肌耐力	低强度组	30	前测	0.89±0.28	-2.293	0.029
			后测	0.93±0.23
	高强度组	30	前测	0.94±0.22	-3.075	0.005
			后测	0.98±0.24
	分组训练前两组均值差			0.05±0.33	-0.776	0.441
	分组训练后两组均值差			0.05±0.29	-0.860	0.393
屈肌耐力	低强度组	30	前测	0.96±0.27	-1.952	0.061
			后测	0.99±0.27
	高强度组	30	前测	1.03±0.12	-3.197	0.003
			后测	1.07±0.13
	分组训练前两组均值差			0.07±0.33	-1.203	0.236
	分组训练后两组均值差			0.08±0.33	-1.402	0.168

变量	组别	n	测试	$\stackrel{-}{x}\pm s$	t值	P值
伸肌相对峰力矩/(N⋅m⋅kg^-1)	低强度组	30	前测	0.66±0.35	-1.715	0.097
			后测	0.78±0.31
	高强度组	30	前测	0.61±0.27	-3.398	0.002
			后测	0.77±0.16
	分组训练前两组均值差			-0.05±0.43	0.609	0.545
	分组训练后两组均值差			-0.01±0.37	0.130	0.897
屈肌相对峰力矩/(N⋅m⋅kg^-1)	低强度组	30	前测	-0.50±0.22	3.030	0.005
			后测	-0.60±0.24
	高强度组	30	前测	-0.49±0.22	4.100	< 0.001
			后测	-0.55±0.24
	分组训练前两组均值差			0.02±0.28	-0.287	0.775
	分组训练后两组均值差			0.05±0.31	-0.722	0.473
伸肌耐力	低强度组	30	前测	0.99±0.14	-0.530	0.600
			后测	1.01±0.27
	高强度组	30	前测	1.03±0.27	-3.420	0.002
			后测	1.07±0.23
	分组训练前两组均值差			0.04±0.27	-0.736	0.465
	分组训练后两组均值差			0.06±0.29	-0.896	0.374
屈肌耐力	低强度组	30	前测	1.02±0.17	-1.518	0.140
			后测	1.06±0.25
	高强度组	30	前测	1.07±0.20	-3.797	0.001
			后测	1.13±0.26
	分组训练前两组均值差			0.05±0.27	-1.110	0.272
	分组训练后两组均值差			0.06±0.38	-0.968	0.337

变量	组别	n	测试	$\stackrel{-}{x}\pm s$	t值	P值
伸肌相对峰力矩/(Nm⋅kg^-1)	低强度组	30	前测	0.73±0.32	-2.541	0.017
			后测	0.81±0.30
	高强度组	30	前测	0.63±0.23	-2.503	0.018
			后测	0.75±0.36
	分组训练前两组均值差			-0.10±0.33	1.366	0.178
	分组训练后两组均值差			-0.07±0.49	0.762	0.449
屈肌相对峰力矩/(Nm⋅kg^-1)	低强度组	30	前测	-0.44±0.22	2.177	0.038
			后测	-0.52±0.26
	高强度组	30	前测	-0.43±0.23	5.863	< 0.001
			后测	-0.49±0.25
	分组训练前两组均值差			0.01±0.29	-0.192	0.848
	分组训练后两组均值差			0.03±0.32	-0.531	0.597
伸肌耐力	低强度组	30	前测	0.86±0.24	-0.714	0.481
			后测	0.87±0.24
	高强度组	30	前测	0.89±0.18	-2.320	0.028
			后测	0.91±0.21
	分组训练前两组均值差			0.03±0.30	-0.585	0.561
	分组训练后两组均值差			0.04±0.33	-0.724	0.472
屈肌耐力	低强度组	30	前测	0.88±0.24	-1.485	0.148
			后测	0.91±0.20
	高强度组	30	前测	0.92±0.15	-3.288	0.003
			后测	0.96±0.16
	分组训练前两组均值差			0.04±0.28	-0.839	0.405
	分组训练后两组均值差			0.05±0.23	-1.146	0.257

不同强度神经肌肉功能训练对前交叉韧带重建术后患者肌力和膝关节功能的影响

Effect of different intensity neuromuscular training on muscle strength and knee joint function of patients after anterior cruciate ligament reconstruction

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