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膝骨性关节炎中医手法与功能锻炼后的生物力学分析 被引量:25

Biomechanical analysis in patients with knee osteoarthritis after Chinese massage combined with functional exercise
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摘要 背景:应用现代步态分析技术诊断、评估膝骨性关节炎患者足底压力分布的报道较少,尚未建立骨性关节炎患者特征性的足底压力数据库。目的:评估中医手法结合功能锻炼对膝关节骨性关节炎的治疗效果。方法:选取符合条件的左侧膝关节骨性关节炎患者40例,随机分为2组。对照组20例采用常规治疗法,治疗组20例运用中医手法结合功能锻炼治疗。分别对治疗前及治疗后3个月的症状体征进行日本矫形外科学会评分及步态测试,比较各组治疗前后疗效的差异。结果与结论:在减轻步行时疼痛方面,治疗组和对照组均有显著疗效,两组疗效差异无显著性意义。治疗组在上下楼梯、关节屈曲活动度方面的效果治疗前后差异显著,对照组则不明显;其中治疗后关节的屈曲活动治疗组显著优于对照组。在消肿方面两组无明显差异。治疗组日本矫形外科学会评分总评分显著高于治疗前(P<0.05),对照组在疗前疗后无统计学差异。在步态指标上,两组足底各区受力时间百分比、单足支撑期参数和足底压力峰值都有改善,但治疗前后差异不明显。而治疗组步角的改善在治疗后效果显著,与对照组相比也具有显著意义。治疗组指标虽然具有诸多方面的改善,但并没有达到正常值。 BACKGROUND: There are less reports on the evaluation of plantar pressure distribution in knee osteoarthritis patients using modern gait analysis, and moreover, the database of characteristic plantar pressure has not been established in patients with osteoarthritis. OBJECTIVE: To evaluate the therapeutic effect of Chinese massage and functional exercise on knee osteoarthritis.METHODS: Forty patients with left knee osteoarthritis who were eligible for the inclusive criteria were randomized into two groups, with 20 in each group. Control group was given conventional treatment, and treatment group was given Chinese massage combined with functional exercise. Japanese Orthopaedic Association score and gait parameters were measured and compared between two groups before and at 3 months after treatment. RESULTS AND CONCLUSION: After treatment, the two groups both had evident efficacy in pain relief during walking, and there was no statistically difference between the two groups. There was a significant difference in the knee range of motion in the patients in the treatment group when going upstairs and downstairs as well as during joint flexion before and after treatment, but no changes occurred in the control group. After treatment, the range of motion during joint flexion was better in the treatment group than the control group, but there was no difference in the swelling reduction between the two groups. In addition, the treatment group had a higher Japanese Orthopaedic Association score after treatment than before treatment (P 〈 0.05), and there was no statistical difference in the control group. Gait analysis showed that there were improvements in the percentage of contact time, parameters during stance phase and peak plantar pressure in the two groups, but there was no significant difference before and after treatment. Foot axis angle in the treatment group was improved significantly, which was significantly better than that in the control group. All the indexes in the treatment group were improved a
出处 《中国组织工程研究》 CAS 北大核心 2015年第33期5351-5355,共5页 Chinese Journal of Tissue Engineering Research
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