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Effects of Different Stretching Techniques on the Outcomes of Isokinetic Exercise in Patients with Knee Osteoarthritis

不同型態的伸展運動對膝關節炎病人等速肌力運動的影響

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摘要


對於膝退化性關節炎的患者,除了藥物治療以外,還有許多非藥物的治療選擇。其中相關肌力強化的運動,是一種很重要的復健處方。對於慢性膝蓋退化性關節炎的患者,常見股四頭肌無力及因為膝蓋疼痛,而導致病人活動力下降,進一步關節活動度減少,甚至攣縮。因此,如何給予適當的活動,來強化股四頭肌以及維持關節活動度,對於病人的生活品質是格外的重要。本研究的目的,在於比較給予病人等速肌力運動前,施以兩種不同的伸展運動,包括靜態的伸展運動以及本體感覺神經肌肉誘發式伸展運動,對於病人的肌力訓練、關節活動度、失能的狀態以及膝蓋的疼痛等之改善程度加以評估。結果發現,有接受等速肌力運動病患,其疼痛的改善、肌力的強化及失能的狀態,皆得到改善。其中有接受伸展運動的兩組受測者,其肌力及關節活動度有顯著的改善。而且接受本體感覺神經肌肉誘發式伸展運動這組的效果,又比接受靜態的伸展運動的受測者為佳。由此可知,對於膝退化性關節炎的患者,給予適當的等速肌力運動,並且在運動前指導伸展運動,是一種較為適合的運動處方。

並列摘要


We recruited 132 subjects with bilateral knee osteoarthritis (Altman Grade II) to compare the effects of different stretching techniques on the outcomes of isokinetic muscle strengthening exercises. Patients were randomly divided into four groups (I-TV). The patients in Group I received isokinetic muscular strengthening exercises, Group TI received bilateral knee static stretching and isokinetic exercises, Group ITT received proprioceptive neuromuscular facilitation (PNF) stretching and isokinetic exercises, and Group TV acted as controls. Outcomes were measured by changes in Lequesne's index, range of knee motion, visual analog pain scale, and peak muscle torques during knee flexion and extension. Patients in all the treated groups experienced significant reductions in knee pain and disability, and increased peak muscle torques after treatment and at follow-up. However, only patients in Groups TI and ITT had significant improvements in range of motion and muscle strength gain during 60°/second angular velocity peak torques. Group ITT demonstrated the greatest increase in muscle strength gain during 180°/second angular velocity peak torques. In conclusion, stretching therapy could increase the effectiveness of isokinetic exercise in terms of functional improvement in patients with knee osteoarthritis. PNF techniques were more effective than static stretching.

並列關鍵字

isokinetic exercise knee osteoarthritis stretching

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