Clinical Motor Function Laboratory, The Parker Institute, Frederiksberg Hospital, Frederiksberg, Denmark.
J Pain. 2011 Apr;12(4):460-7. doi: 10.1016/j.jpain.2010.10.004. Epub 2010 Dec 13.
Pain is the principal symptom in knee pathologies and reduced muscle strength is a common observation among knee patients. However, the relationship between knee joint pain and muscle strength remains to be clarified. This study aimed at investigating the changes in knee muscle strength following experimental knee pain in healthy volunteers, and if these changes were associated with the pain intensities. In a crossover study, 18 healthy subjects were tested on 2 different days. Using an isokinetic dynamometer, maximal muscle strength in knee extension and flexion was measured at angular velocities 0, 60, 120, and 180 degrees/second, before, during, and after experimental pain induced by injections of hypertonic saline into the infrapatellar fat pad. On a separate day, isotonic saline injections were used as control condition. The pain intensity was assessed on a 0- to 100-mm visual analogue scale. Knee pain reduced the muscle strength by 5 to 15% compared to the control conditions (P < .001) in both knee extension and flexion at all angular velocities. The reduction in muscle strength was positively correlated to the pain intensity. Experimental knee pain significantly reduced knee extension and flexion muscle strength indicating a generalized muscle inhibition augmented by higher pain intensities.
This study showed that knee joint pain has a significant impact on muscle function. The findings provide evidence of a direct inhibition of muscle function by joint pain, implying that rehabilitative strengthening exercises may be antagonized by joint pain.
疼痛是膝关节病变的主要症状,膝关节患者普遍存在肌肉力量减弱的情况。然而,膝关节疼痛与肌肉力量之间的关系仍需阐明。本研究旨在调查健康志愿者膝关节疼痛实验后膝关节肌肉力量的变化,以及这些变化是否与疼痛强度有关。在一项交叉研究中,18 名健康受试者在 2 天内接受测试。使用等速测力计,在 0、60、120 和 180 度/秒的角速度下测量膝关节伸展和屈曲的最大肌肉力量,在向髌下脂肪垫注射高渗盐水引起实验性疼痛之前、期间和之后进行测量。在另一天,使用等渗盐水注射作为对照条件。使用 0 到 100 毫米视觉模拟量表评估疼痛强度。与对照条件相比(P <.001),膝关节疼痛在所有角速度下均使膝关节伸展和屈曲的肌肉力量降低了 5%至 15%。肌肉力量的降低与疼痛强度呈正相关。实验性膝关节疼痛显著降低了膝关节伸展和屈曲的肌肉力量,表明更高的疼痛强度增强了全身性肌肉抑制。
本研究表明膝关节疼痛对肌肉功能有重大影响。研究结果提供了关节疼痛直接抑制肌肉功能的证据,这意味着康复性强化锻炼可能会因关节疼痛而受到拮抗。