肖骏,叶慧敏,林广勇,等.Mulligan动态关节松动术联合渐进式抗阻训练治疗血友病性膝关节炎的疗效观察[J].中华物理医学与康复杂志,2026,48(2):135-140
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| Mulligan动态关节松动术联合渐进式抗阻训练治疗血友病性膝关节炎的疗效观察 |
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| DOI：10.3760/cma.j.cn421666-20250627-00535 |
| 中文关键词: Mulligan 动态关节松动术 血友病性膝关节炎 渐进式抗阻训练 膝关节滑膜增生厚度 |
| 英文关键词: Mulligan mobilization Hemophilic knee arthritis Resistance training Synovial hyperplasia |
| 基金项目:佛山市卫生健康医学科研项目 (20250305) |
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| 中文摘要: |
| 目的 观察 Mulligan 动态关节松动术联合渐进式抗阻训练治疗血友病性膝关节炎的临床疗效。方法 选取血友病性膝关节炎男性患者 50 例，随机分为对照组与观察组，每组 25 例。两组均给予渐进式抗阻训练，观察组在此基础上辅以 Mulligan 动态关节松动术治疗。治疗前及治疗 12 周后，B 超测量膝关节滑膜增生厚度及积液深度，采用国际预防研究小组 (IPSG) 关节健康状况评分量表、中国版血友病早期关节病超声检测 (HEAD-US-C) 评分、血友病关节健康评分 2.1 版 (HJHS2.1)、疼痛视觉模拟评分法 (VAS)、Lysholm 膝关节评分量表 (LKSS) 评定疗效。结果 与组内治疗前比较，两组治疗后膝关节滑膜增生厚度降低、积液量减少，IPSG 关节健康状况评分、HEAD-US-C 评分、HJHS2.1 评分及 VAS 评分降低，LKSS 评分增加（P<0.05）。与对照组比较，观察组治疗后膝关节滑膜增生厚度 [0.30 (0.00，2.20) mm] 与积液量 [0.00 (0.00，0.00) mm] 改善更优，IPSG 关节健康状况评分 [(5.72±3.65) 分]、HEAD-US-C 评分 [2.00 (0.00，5.00) 分]、HJHS2.1 评分 [5.00 (3.00，8.00) 分] 及 VAS 评分更低，LKSS 评分更高（P<0.05）。结论 在渐进式抗阻训练基础上增加 Mulligan 动态关节松动术干预，能有效降低血友病性膝关节炎患者膝关节滑膜增生厚度、减少积液量，改善膝关节疼痛程度、活动度及功能，值得临床应用推广。 |
| 英文摘要: |
| Objective To observe the clinical efficacy of combining Mulligan knee mobilization with movement (MWM) with progressive resistance training in the treatment of hemophilic knee arthritis. Methods Fifty men with hemophilic knee arthritis were randomly divided into a control group and an observation group, each of 25. Both groups received progressive resistance training, while the observation group was additionally provided with MWM therapy. Before and after 12 weeks of the treatment, synovial proliferation thickness and effusion depth in the knee were measured using B-mode ultrasound. Therapeutic efficacy was evaluated using the International Prophylaxis Study Group (IPSG) joint health instrument, the Chinese version of the Hemophilia Early Arthropathy Detection with Ultrasound (HEAD-US-C) scale, version 2.1 of the Hemophilia Joint Health Score (HJHS2.1), a visual analog scale (VAS), and the Lysholm Knee Scoring Scale (LKSS). Results After treatment, both groups showed significant reductions in knee synovial proliferation thickness, effusion depth, IPSG joint health score, HEAD-US-C score, HJHS2.1 score, and VAS knee pain scores, along with an increase in average LKSS scores. The observation group demonstrated greater improvement than the control group, on average. Conclusions Combining Mulligan mobilization with progressive resistance training can effectively reduce knee synovial proliferation thickness and effusion depth, increase range of motion, and generally improve the knee function of persons with hemophilic knee arthritis. It also relieves pain. This combined approach is worthy of clinical application and promotion. |
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