水中抗阻训练对膝关节置换后活动受限和下肢功能障碍的影响。

Effects of aquatic resistance training on mobility limitation and lower-limb impairments after knee replacement.

机构信息

Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland.

出版信息

Arch Phys Med Rehabil. 2010 Jun;91(6):833-9. doi: 10.1016/j.apmr.2010.03.002.

DOI:10.1016/j.apmr.2010.03.002

PMID:20510971

Abstract

OBJECTIVE

To study the effects of aquatic resistance training on mobility, muscle power, and cross-sectional area.

DESIGN

Randomized controlled trial.

SETTING

Research laboratory and hospital rehabilitation pool.

PARTICIPANTS

Population-based sample (N=50) of eligible women and men 55 to 75 years old 4 to 18 months after unilateral knee replacement with no contraindications who were willing to participate in the trial.

INTERVENTIONS

Twelve-week progressive aquatic resistance training (n=26) or no intervention (n=24).

MAIN OUTCOME MEASURES

Mobility limitation assessed by walking speed and stair ascending time, and self-reported physical functional difficulty, pain, and stiffness assessed by Western Ontario and McMaster University Osteoarthritis Index (WOMAC) questionnaire. Knee extensor power and knee flexor power assessed isokinetically, and thigh muscle cross-sectional area (CSA) by computed tomography.

RESULTS

Compared with the change in the control group, habitual walking speed increased by 9% (P=.005) and stair ascending time decreased by 15% (P=.006) in the aquatic training group. There was no significant difference between the groups in the WOMAC scores. The training increased knee extensor power by 32% (P<.001) in the operated and 10% (P=.001) in the nonoperated leg, and knee flexor power by 48% (P=.003) in the operated and 8% (P=.002) in the nonoperated leg compared with controls. The mean increase in thigh muscle CSA of the operated leg was 3% (P=.018) and that of the nonoperated leg 2% (P=.019) after training compared with controls.

CONCLUSIONS

Progressive aquatic resistance training had favorable effects on mobility limitation by increasing walking speed and decreasing stair ascending time. In addition, training increased lower limb muscle power and muscle CSA. Resistance training in water is a feasible mode of rehabilitation that has wide-ranging positive effects on patients after knee replacement surgery.

摘要

目的

研究水中抗阻训练对活动能力、肌肉力量和横截面积的影响。

设计

随机对照试验。

地点

研究实验室和医院康复池。

参与者

从符合条件的女性和男性中抽取的人群样本（N=50），年龄在 55 至 75 岁之间，在单侧膝关节置换术后 4 至 18 个月，无禁忌症，愿意参加试验。

干预

为期 12 周的渐进式水中抗阻训练（n=26）或无干预（n=24）。

主要观察指标

通过步行速度和爬楼梯时间评估活动能力受限情况，通过 Western Ontario and McMaster University Osteoarthritis Index（WOMAC）问卷评估自我报告的身体功能困难、疼痛和僵硬程度。通过等速运动评估膝关节伸肌力量和膝关节屈肌力量，通过计算机断层扫描评估大腿肌肉横截面积（CSA）。

结果

与对照组相比，水中训练组的习惯性步行速度提高了 9%（P=.005），爬楼梯时间减少了 15%（P=.006）。两组 WOMAC 评分无显著差异。与对照组相比，训练使手术侧膝关节伸肌力量增加了 32%（P<.001），非手术侧增加了 10%（P=.001），膝关节屈肌力量增加了 48%（P=.003），非手术侧增加了 8%（P=.002）。与对照组相比，手术后大腿肌肉 CSA 的平均增加量为手术侧 3%（P=.018），非手术侧 2%（P=.019）。