摘要
目的观察基于表面肌电图的手法治疗对老年人膝骨关节炎(KOA)的临床疗效。方法选取2023年8月至2024年6月上海中医药大学附属曙光医院单侧KOA患者106例,随机分为对照组和试验组,各53例。对照组采用常规手法治疗,试验组采用基于平均肌电(AEMG)制定的手法,共4周。治疗前后采用西安大略和麦克马斯特大学骨关节炎指数(WOMAC)、疼痛视觉模拟量表(VAS)、Tinetti平衡与步态评分和6分钟步行试验(6-MWT)距离进行评定。结果两组各脱落1例。治疗前,试验组患侧股直肌、股内侧肌、腓肠肌内侧头AEMG显著低于健侧(|Z|>8.647,P<0.001),患侧股外侧肌、半腱肌、股二头肌AEMG值显著高于健侧(|Z|>4.808,P<0.001)。治疗后两组WOMAC、VAS、Tinetti平衡与步态评分和6-MWT距离均较前显著改善(|t|>3.987,P<0.001),除VAS评分外,试验组各项指标均优于对照组(|t|>2.213,P<0.05)。结论基于表面肌电图结果,将激活股直肌、股内侧肌、腓肠肌内侧头,抑制股外侧肌、半腱肌、股二头肌和释放内、外侧副韧带张力作为手法操作重点,可缓解老年人KOA疼痛,改善膝关节活动能力。
Objective To investigate the effect of manual therapy based on surface electromyography on knee osteoarthritis(KOA)in the older people.Methods A total of 106 outpatient with unilateral KOA were selected from Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,from August,2023 to June,2024,and were randomly divided into control group(n = 53) and experimental group(n = 53).The control group accepted routine manual therapy,and the experimental group accepted manual therapy based on the analysis of average electromyography(AEMG).They were assessed with Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC),Visual Analogue Scale(VAS) for pain,Tinetti Balance and Gait Score,and 6-minute walk test(6-MWT) distances before and after treatment.Results One case dropped down in each group.Before treatment,AEMG decreased in the rectus femoris,medial femoris and medial head of gastrocnemius on the affected side in the experimental group(|Z| > 8.647,P < 0.001),and it increased in the lateral femoris,semitendinosus and biceps femoris(|Z| > 4.808,P < 0.001).The scores of WOMAC,VAS,Tinetti Balance and Gait Score,and distances of 6-MWT improved in both groups after treatment(|t| > 3.987,P < 0.001),and improved more in the experimental group than in the control group,except the VAS score(|t| > 2.213,P < 0.05).Conclusion Manual therapy focusing on activation of rectus femoris,medial femoris and medial head of gastrocnemius,inhibition of the lateral femoris,semitendinosus and biceps femoris,and releasing the tension of the medial and lateral collateral ligaments,according to the results of surface electromyography,can alleviate the pain of the KOA in the older people and improve the mobility of the knee.
作者
朱博文
赵素红
李苗秀
张帅攀
姚重界
朱清广
房敏
ZHU Bowen;ZHAO Suhong;LI Miaoxiu;ZHANG Shuaipan;YAO Chongjie;ZHU Qingguang;FANG Min(Department of Tuina,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;College of Acupuncture and Tuina,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Shanghai Institute of Traditional Chinese Medicine,Shanghai 200437,China;Department of Tuina,Yueyang Hospital of Integrative Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)
出处
《中国康复理论与实践》
CSCD
北大核心
2024年第9期1099-1106,共8页
Chinese Journal of Rehabilitation Theory and Practice
基金
国家自然科学基金项目(No.82305424)
老年筋骨病中医智能康复设备创新研发平台项目(No.SHDC2022CRT018)
上海市创新医疗器械应用示范项目(No.23SHS05400)
上海市科技启明星"扬帆专项"(No.22YF1449000)
中华中医药学会青年托举人才项目(No.CACM-2023-QNRC2-B13)
上海市东方英才青年项目(卫生平台)
上海市申康中心示范性研究型病房建设项目(No.SHDC2022CRW010)。
关键词
膝骨关节炎
老年
表面肌电图
手法治疗
随机对照试验
knee osteoarthritis
aged
surface electromyography
manual therapy
randomized controlled trial
