| 苏婵娟,李捷婷,陈耿钊,陈 博,刘丽金,陈 昕.基于多通道表面肌电评价等速肌力训练对膝骨关节炎患者的影响[J].中国康复医学杂志,2026,(8):1268~1276 |
| 基于多通道表面肌电评价等速肌力训练对膝骨关节炎患者的影响 点此下载全文 |
| 苏婵娟 李捷婷 陈耿钊 陈 博 刘丽金 陈 昕 |
| 福州市第二总医院，福州市，350007 |
| 基金项目：福州市卫生健康中青年科学研究项目（2021-S-wq3）；福州市卫生健康中青年科学研究项目（2021-S-wq10）；福建省创伤骨科急救与康复临床医学研究中心（2020Y2014） |
| DOI：10.3969/j.issn.1001-1242.2026.08.011 |
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| 摘要： |
| 摘要
目的：应用表面肌电图观察和分析膝骨关节炎（knee osteoarthritis， KOA）患者在等速肌力训练前后股四头肌表面肌电活动。
方法：分别在等速肌力训练前和训练6周后，采用全无线肌电测试系统评测29例KOA患者在不同角速度（60°/s、90°/s、180°/s）膝关节屈伸运动等速肌力测试下股外侧肌、股直肌和股内侧肌的表面肌电图。并记录其股外侧肌、股直肌和股内侧肌肌肉厚度与膝关节功能评分，以评估肌电数据和临床指标的相关性。
结果：①训练后，在角速度为60°/s等速肌力测试时，受试者股外侧肌（P<0.05）、股直肌（P<0.05）、股内侧肌（P<0.001）的积分肌电升高具有显著性意义；股内侧肌的中值频率（P<0.05）、肌肉贡献率（P<0.05）、均方根值（P<0.001）在等速肌力治疗前后存在显著性差异。角速度为90°/s时，股外侧肌肌肉贡献率（P<0.01）、股直肌均方根值（P<0.01）存在显著性差异；股内侧肌积分肌电（P<0.001）、肌肉贡献率（P<0.001）、均方根值（P<0.001）升高存在显著性差异。角速度为180°/s时，股外侧肌（P<0.05）、股直肌（P<0.05）均方根值存在显著性差异，股内侧肌中值频率（P<0.001）、肌肉贡献率（P<0.05）具有显著性意义。②训练后，在60°/s等速肌力测试时，受试者膝关节屈肌峰值力矩（P<0.001）与伸肌峰值力矩（P<0.001）对比治疗前均存在显著性差异。在角速度为180°/s等速肌力测试时，膝关节屈肌总功（P<0.001）与伸肌总功（P<0.001）存在显著性差异。膝关节屈/伸肌峰力矩比（H/Q）在60°/s（P<0.001）和90°/s（P<0.001）等速肌力测试时存在显著性差异。③在等速肌力训练前后，股四头肌肌肉厚度具有显著性差异（P<0.01）；膝关节功能评分：疼痛（P<0.001）、肿胀（P<0.001）、爬楼梯（P<0.001）、下蹲（P<0.001）、跛行（P<0.001）、支持物（P<0.001）、关节交锁（P<0.05）、不稳定（P<0.05）均具有显著性意义。④在多元线性回归分析中，等速肌力治疗后股内侧肌与支持的关系最为显著。在基于随机森林算法的数据回归分析中，治疗后患者在股内侧肌放松时，其肌肉贡献率在各不同角速度等速肌力测试时与肌肉厚度回归的重要性均最高。在股内侧肌收缩时，角速度为60°/s、90°/s等速肌力测试下肌肉贡献率与肌肉厚度回归最高，在180°/s时中值频率最高，其次为肌肉贡献率。
结论：等速肌力训练可以显著改善KOA患者股四头肌肌力、膝关节稳定性，其中以股内侧肌强化效果较为明显。 |
| 关键词：膝骨关节炎 股四头肌 股内侧肌 等速肌力训练 表面肌电图 回归分析 |
| Evaluation of the effect of isokinetic muscle strength training on knee osteoarthritis patients based on multichannel surface electromyography characteristics Download Fulltext |
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| Fuzhou Second General Hospital， Fuzhou， 350007 |
| Fund Project: |
| Abstract: |
| Abstract
Objective： To observe and analyze the surface electromyography activity of the quadriceps femoris of the knee osteoarthritis （KOA） patients before and after isokinetic muscle strength training.
Method： The surface electromyography of vastus lateralis， rectus femoris， and vastus medialis were recorded and analyzed in 29 KOA patients undergoing isokinetic knee flexion and extension at velocities of 60°/s， 90°/s， 180°/s before and after 6 weeks of isokinetic muscle strength training. We also recorded clinical indicators （muscle thickness and knee joint function） and evaluated the correlations between electromyographic data and clinical indicators.
Result： ①After 6 weeks of isokinetic muscle strength training， statistics showed that there were significant differences in the integrated electromyography of vastus lateralis （P<0.05）， rectus femoris （P<0.05）， and vastus medialis （P<0.01） under isokinetic knee flexion and extension testing at velocities of 60°/s. Meanwhile， there were significant differences in the median frequency （P<0.05）， muscle contribution ratio （P<0.05）， and root mean square value （P<0.001） of vastus medialis. Statistics revealed that the muscle contribution ratio of vastus lateralis （P<0.01） and the root mean square value of rectus femoris （P<0.01） changed significantly at velocities of 90°/s. Simultaneously， there were significant differences in the integrated electromyography （P<0.001）， muscle contribution ratio （P<0.001）， and root mean square value （P<0.001） of vastus medialis. There were significant differences in the root mean square values of vastus lateralis （P<0.05） and rectus femoris （P<0.05） at velocities of 180 °/s. And the median frequency （P<0.001） and muscle contribution ratio （P<0.05） of vastus medialis showed statistically significant differences. ②After 6 weeks of isokinetic muscle strength training， statistics showed that there were significant differences both in the peak torque of knee flexors （P<0.001） and peak torque of extensors （P<0.001） under isokinetic knee flexion and extension testing at velocities of 60°/s. And there were significant differences both in the total work of knee flexors （P<0.001） and extensors （P<0.001） at velocities of 180°/s. A significant difference was observed in the hamstrings-to-quadriceps peak torque ratio （H/Q） under isokinetic knee flexion and extension testing at velocities of both 60°/s and 90°/s. ③After 6 weeks of isokinetic muscle strength training， statistics showed that there were significant differences in the quadriceps muscle thickness （P<0.01） under isokinetic knee flexion and extension testing. Meanwhile， there were significant differences in the Lysholm knee scoring scale [pain（P<0.001），instability（P<0.001），locking（P<0.001），swelling（P<0.001），walking ability（P<0.001），using stairs （P<0.001），squatting（P<0.05），use of supports（P<0.05）]. ④The results of multiple linear regression analysis showed that the relationship between the vastus medialis and support was the most significant after isokinetic muscle strength treatment. The results of random forest algorithm showed that the importance of muscle contribution ratio and muscle thickness was the highest after the test at various angular velocities upon the relaxation of the vastus medialis. During contraction of the vastus medialis muscle， the muscle contribution ratio and muscle thickness were the highest during the isokinetic muscle strength test at velocities of 60°/s and 90°/s. Meanwhile， the median frequency was the highest， followed by the muscle contribution ratio at velocities of 180°/s.
Conclusion： Isokinetic muscle strength training can improve muscle function and knee joint stability in patients with KOA， with a more pronounced effect on strengthening the vastus medialis. |
| Keywords:knee osteoarthritis quadriceps femoris vastus medialis isokinetic muscle strength training surface electromyography regressive analysis |
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