Gür Hakan, Cakin Nilgün
Department of Sports Medicine, Medical College of Uludag University, Bursa, Turkey.
Arch Phys Med Rehabil. 2003 Oct;84(10):1534-41. doi: 10.1016/s0003-9993(03)00288-0.
To investigate the relations between cross-sectional area and concentric and eccentric torques in the quadriceps and hamstring muscles and to determine how functional capacity relates to pain, muscle mass, and concentric and eccentric knee torques in women who have bilateral osteoarthritis (OA) of the knee.
Randomized, descriptive study.
A university exercise physiology laboratory in Turkey.
Eighteen women with bilateral knee OA (grades 2 or 3) graded radiographically.
Not applicable.
Selected functional tests included the 15-m walk, rising from a chair, descending stairs, and stair climbing. Pain during the functional tests was subjectively measured on an 11-point scale (range, 0-10). Concentric and eccentric torques of the quadriceps and hamstring muscles were measured by isokinetic dynamometry with angular velocities of 60 degrees, 120 degrees, and 180 degrees /s; cross-sectional areas of the quadriceps and hamstring muscles were measured by computed tomography.
Eccentric torque was significantly (P range, <.05 to.001) greater than concentric torque for the quadriceps (range, 16%-100%) and hamstring (range, 50%-158%) muscles at all angular velocities. Torque-velocity curves for concentric and eccentric contractions were almost identical to those found in healthy young and elderly people. According to r(2) values, cross-sectional area of the quadriceps and hamstring muscles explained 24% to 61% (r(2) range,.24-.61) and 38% to 51% (r(2) range,.38-.51) of the variations in concentric and eccentric peak torques, respectively. Very small to moderate correlations (.01-.75) were observed among torque at any velocity and the variables of functional capacity and pain. For stair-climbing times, the best predictor variable was the eccentric hamstring to concentric quadriceps torque ratio. For stair descending, it was the concentric hamstring to eccentric quadriceps torque ratios. These torque ratios explained 81% (r(2)=.81) and 61% (r(2)=.61) of the variations, respectively.
The findings in a patient group with bilateral OA of the knee showed that (1) eccentric torque is greater than concentric torque in knee muscles; (2) the correlation coefficients (r) between concentric and eccentric torques at different velocities (r range,.63-.86), but not between reciprocal torque ratios (r range,.02-.69), are good; (3) cross-sectional area cannot be considered as a single predictor of peak torque for either quadriceps or hamstring muscles; and (4) the variation in descending stairs and stair-climbing capacities can be explained by the reciprocal torque ratios of knee muscles.
研究股四头肌和腘绳肌的横截面积与向心和离心扭矩之间的关系,并确定功能能力与双侧膝关节骨关节炎(OA)女性的疼痛、肌肉质量以及向心和离心膝关节扭矩之间的关系。
随机描述性研究。
土耳其一所大学的运动生理学实验室。
18名经X光片分级为双侧膝关节OA(2级或3级)的女性。
不适用。
选定的功能测试包括15米步行、从椅子上起身、下楼梯和爬楼梯。功能测试期间的疼痛采用11分制主观测量(范围为0 - 10)。股四头肌和腘绳肌的向心和离心扭矩通过等速测力法测量,角速度分别为60度、120度和180度/秒;股四头肌和腘绳肌的横截面积通过计算机断层扫描测量。
在所有角速度下,股四头肌(范围为16% - 100%)和腘绳肌(范围为50% - 158%)的离心扭矩显著(P值范围为<.05至.001)大于向心扭矩。向心和离心收缩的扭矩 - 速度曲线与健康年轻人和老年人的曲线几乎相同。根据r²值,股四头肌和腘绳肌的横截面积分别解释了向心和离心峰值扭矩变化的24%至61%(r²范围为.24 -.61)和38%至51%(r²范围为.38 -.51)。在任何速度下的扭矩与功能能力和疼痛变量之间观察到非常小到中等程度的相关性(.01 -.75)。对于爬楼梯时间,最佳预测变量是腘绳肌离心扭矩与股四头肌向心扭矩之比。对于下楼梯,是腘绳肌向心扭矩与股四头肌离心扭矩之比。这些扭矩比分别解释了81%(r² =.81)和61%(r² =.61)的变化。
双侧膝关节OA患者组的研究结果表明:(1)膝关节肌肉的离心扭矩大于向心扭矩;(2)不同速度下向心和离心扭矩之间的相关系数(r)良好(r范围为.63 -.86),但反向扭矩比之间的相关系数(r范围为.02 -.69)不佳;(3)横截面积不能被视为股四头肌或腘绳肌峰值扭矩的单一预测指标;(4)下楼梯和爬楼梯能力的变化可以通过膝关节肌肉的反向扭矩比来解释。