Durand A, Richards C L, Malouin F
Neurobiology Research Center, Hôpital de l'Enfant-Jésus, Quebec, Canada.
Clin Orthop Relat Res. 1991 Jan(262):210-26.
Maximal isokinetic strength and electromyographic activity of the operated leg were measured preoperatively and one, two, three, and eight weeks postoperatively after a partial medial meniscectomy by arthroscopy in a group of ten patients. Strength deficits, measured with a Kin-Com dynamometer using a static preloading protocol, were found in comparison with a group of matched healthy subjects preoperatively and three and eight weeks postoperatively in the knee extensors. These deficits were related to previously unreported modifications in the shape of the moment-angle curves and a tendency to lower activation levels of the vastus medialis (VM) but not the vastus lateralis or rectus femoris muscles. No deficits were found in the knee flexors preoperatively or three and eight weeks postoperatively, but the medial hamstrings activation level was lower for movements at 30 degrees per second. During flexion movements, the percentage of coactivation of the antagonist VM was significantly greater than healthy values at 30 degrees and 180 degrees per second. These results clearly indicate that neuromuscular recovery is not complete when return to work is advocated three to four weeks postoperatively. Such findings suggest the need for a rehabilitation program to promote recovery of the knee muscles in workers with a physically demanding occupation.
对一组10例患者在关节镜下进行部分内侧半月板切除术后,于术前以及术后1周、2周、3周和8周测量患侧腿的最大等速肌力和肌电图活动。采用Kin-Com测力计,通过静态预加载方案测量肌力缺损,结果发现,与一组匹配的健康受试者相比,术前以及术后3周和8周时,膝关节伸肌存在肌力缺损。这些缺损与力矩-角度曲线形状的先前未报道的改变以及股内侧肌(VM)激活水平降低的趋势有关,但股外侧肌或股直肌未出现这种情况。术前以及术后3周和8周时,膝关节屈肌未发现肌力缺损,但在每秒30度运动时,内侧腘绳肌的激活水平较低。在屈曲运动期间,在每秒30度和180度时,拮抗肌VM的共同激活百分比显著高于健康值。这些结果清楚地表明,在术后三到四周主张恢复工作时,神经肌肉恢复并不完全。这些发现表明,对于从事体力要求较高职业的工人,需要一个康复计划来促进膝关节肌肉的恢复。