施爱梅,郑琦,李小龙,等.血流限制训练对前交叉韧带重建术后膝本体感觉及运动协调性的影响[J].中华物理医学与康复杂志,2023,45(4):341-345
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| 血流限制训练对前交叉韧带重建术后膝本体感觉及运动协调性的影响 |
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| DOI：10.3760/cma.j.issn.0254-1424.2023.04.011 |
| 中文关键词: 血流限制训练 前交叉韧带重建术 本体感觉 运动协调 |
| 英文关键词: Blood flow restriction Anterior cruciate ligament reconstruction Proprioception Motor coordination |
| 基金项目:浙江省医药卫生科技计划项目（2021KY1113） |
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| 中文摘要: |
| 目的 观察血流限制训练对前交叉韧带(ACL)重建术后患者膝关节本体感觉及运动协调性的影响。 方法 将纳入的30例ACL重建术患者按随机数字表法分为对照组和治疗组，每组15例，2组患者均给予常规康复训练，治疗组在此基础上辅以血流限制训练，训练过程中腹股沟部保持恒定压力以限制下肢血流，包括膝屈伸抗阻训练、蹲站训练、膝屈伸交替训练和功率自行车训练，每周3次，每次约45 min，共治疗8周。分别于治疗前和治疗8周后（治疗后），采用Lysholm膝关节量表、Humac（Norm型）等速测试仪评估系统以及表面肌电时序分析系统评定2组患者的膝关节功能、本体感觉及下肢运动协调功能。 结果 治疗前，2组患者Lysholm评分、膝重现角度差值及下肢运动协同收缩率组间比较，差异均无统计学意义（P＞0.05）。治疗后，治疗组和对照组患者的Lysholm评分［（87.06±5.16）分、（83.27±4.32）分］及膝重现角度差值［（4.13±1.12）°、（6.86±1.68）°］均较组内治疗前［治疗组（57.86±5.99）分和（16.53±1.76）°；对照组（56.47±5.25）分和（17.86±2.51）°］明显改善（P＜0.05），且治疗组明显优于对照组（P＜0.05）。治疗后，最大等长收缩过程中，治疗组患侧的伸展时协同收缩率（股二头肌/股外侧肌）为（30.26±5.95）%，较组内治疗前［（42.93±10.61）%］有明显改善（P＜0.05）；治疗组患侧的屈曲时协同收缩率（股外侧肌/股二头肌）为（23.07±8.65）%，较组内治疗前［（36.94±12.62）%］明显改善（P＜0.05），且明显优于对照组治疗后［（30.36±6.38）%］，组间差异有统计学意义（P＜0.05）；而2组患侧与健侧比较，差异均无统计学意义（P＞0.05）。 结论 血流限制训练可显著改善ACL重建术后患者膝关节功能、本体感觉及运动协调性。 |
| 英文摘要: |
| Objective To explore any effect of blood flow restriction during exercise on knee proprioception and motor coordination after anterior cruciate ligament (ACL) reconstruction. Methods Thirty patients recovering from ACL reconstruction were randomly divided into an experimental group and a control group, each of 15. Both groups were given routine rehabilitation training, while the experimental group was additionally provided with 45 minutes of training with blood flow restriction, 3 times a week for 8 weeks. The blood flow restriction training involved constant pressure in the groin while the patient performed knee flexion and extension resistance training, squats, alternate knee flexion and extension and ergometer cycling. Before and after the intervention, both groups′ knee function, proprioception and lower limb motor coordination were evaluated using the Lysholm knee scale, the Humac isokinetic measurement system and surface electromyography. Results Before the experiment there were no significant differences between the two groups in any of the measurements. After the intervention, both groups′ average Lysholm score had improved significantly, and errors in reproducing a knee angle had decreased significantly. Significantly better improvement was observed in the observation group than in the control group. That group′s average coordinated contraction rate on the affected side in extension and flexion was also significantly better than the control group′s ave-rage. Indeed, there were no significant differences in the contraction rates between the healthy and affected sides. Conclusions Training with restricted blood flow can significantly improve knee function, proprioception and motor coordination after anterior cruciate ligament reconstruction. |
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