[中医推拿对膝骨关节炎患者等速肌力的影响]

[Effect of Chinese massage (Tui Na) on isokinetic muscle strength in patients with knee osteoarthritis].

作者信息

Zhu Qingguang, Li Jianhua, Fang Min, Gong Li, Sun Wuquan, Zhou Nan

出版信息

J Tradit Chin Med. 2016 Jun;36(3):314-20. doi: 10.1016/s0254-6272(16)30043-7.

DOI:10.1016/s0254-6272(16)30043-7

PMID:27468545

Abstract

OBJECTIVE

Chinese massage (Tui Na) is one of the most popular Traditional Chinese Medicine remedies for knee osteoarthritis (OA). Several studies have subjectively evaluated the effect of Chinese massage on knee OA through self-assessment questionnaires; however, very few studies have objectively assessed the effect by measuring knee muscle strength. The purpose of this study was to assess the efficacy of Chinese massage in improving knee extensor and flexor muscle strength in patients with knee OA.

METHODS

Thirty patients with knee OA received Chinese massage therapy three times per week for 2 weeks. Patients completed pre- and post-treatment Visual Analogue Scale (VAS) pain questionnaires, and pre- and post-treatment knee muscle strength was evaluated using the Biodex Multi-Joint System 3. Isokinetic muscle strength measurements were performed at 60 degrees/s and 180 degrees/s. The peak torque (PT), peak torque/body weight(PT/BW), total work (TW), average power (AP), hamstring/quadriceps (H/Q), and range of motion (ROM) values were recorded separately for flexors and extensors.

RESULTS

Chinese massage therapy significantly improved knee pain as assessed by the VAS in patients with knee OA (P < 0.05). Post-treatment values were significantly greater than pre-treatment values in the extensor muscles for PT (right P = 0.013, left P = 0.001), PT/BW (right P = 0.008, left P = 0.001) and TW (right P = 0.036, left P = 0.004) at 60 degrees/s. The AP increased significantly after treatment in the flexor muscles in the right knee (P = 0.009) and the extensor muscles in the left knee (P = 0.001). There were no significant differences in pre- and post-treatment ROM and H/Q at 60 degrees/s and 180 degrees/s.

CONCLUSION

Chinese massage therapy decreased pain and may improve extensor muscle strength in patients with knee OA, but does not appear to improve ROM.

摘要

目的

中医按摩（推拿）是治疗膝关节骨关节炎（OA）最常用的中医疗法之一。多项研究通过自我评估问卷主观评价了中医按摩对膝关节OA的疗效；然而，很少有研究通过测量膝关节肌肉力量来客观评估其效果。本研究旨在评估中医按摩对改善膝关节OA患者膝关节伸肌和屈肌力量的疗效。

方法

30例膝关节OA患者接受中医按摩治疗，每周3次，共2周。患者完成治疗前和治疗后的视觉模拟量表（VAS）疼痛问卷，并使用Biodex多关节系统3评估治疗前和治疗后的膝关节肌肉力量。在60度/秒和180度/秒的速度下进行等速肌力测量。分别记录屈肌和伸肌的峰值扭矩（PT）、峰值扭矩/体重（PT/BW）、总功（TW）、平均功率（AP）、腘绳肌/股四头肌（H/Q）和运动范围（ROM）值。

结果

中医按摩疗法显著改善了膝关节OA患者的膝关节疼痛（P<0.05）。在60度/秒时，治疗后伸肌的PT（右侧P=0.013，左侧P=0.001）、PT/BW（右侧P=0.008，左侧P=0.001）和TW（右侧P=0.036，左侧P=0.004）值显著高于治疗前。治疗后，右膝屈肌（P=0.009）和左膝伸肌（P=0.001）的AP显著增加。在60度/秒和180度/秒时，治疗前后的ROM和H/Q无显著差异。