快速膝关节伸展以增加全膝关节置换患者股四头肌肌肉活动：一项随机交叉研究。

RAPID KNEE-EXTENSIONS TO INCREASE QUADRICEPS MUSCLE ACTIVITY IN PATIENTS WITH TOTAL KNEE ARTHROPLASTY: A RANDOMIZED CROSS-OVER STUDY.

作者信息

Husted Rasmus Skov, Wilquin Lousia, Jakobsen Thomas Linding, Holsgaard-Larsen Anders, Bandholm Thomas

机构信息

Faculty of Health and Technology, Department of Physiotherapy and Occupational Therapy, Metropolitan University College Copenhagen, Denmark.

Orthopaedic Research Unit, Department of Orthopaedics and Traumatology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.

出版信息

Int J Sports Phys Ther. 2017 Feb;12(1):105-116.

PMID:28217421

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5294937/

Abstract

BACKGROUND

Inhibition of the quadriceps muscle and reduced knee-extension strength is common shortly following total knee arthroplasty (weeks to months), due to reduced voluntary activation of the quadriceps muscle. In healthy subjects, strength training with heavy loads is known to increase agonist muscle activity, especially if the exercise is conducted using rapid muscle contractions.

PURPOSE

The purpose of this study was to examine if patients with total knee arthroplasty could perform rapid knee-extensions using a 10 RM load four to eight weeks after surgery, and the degree to which rapid knee-extensions were associated with greater voluntary quadriceps muscle activity during an experimental strength training session, compared to that elicited using slow knee-extensions.

STUDY DESIGN

A randomized cross-over study.

METHODS

Twenty-four patients (age 66.5) 4-8 weeks post total knee arthroplasty randomly performed one set of five rapid, and one set of five slow knee-extensions with the operated leg, using a load of their 10 repetition maximum, while surface electromyography recordings were obtained from the vastus medialis and lateralis of the quadriceps muscle.

RESULTS

Data from 23 of the 24 included patients were analyzed. Muscle activity was significantly higher during rapid knee-extensions (120.2% [10-90 percentile: 98.3-149.1]) compared to slow knee-extensions (106.0% [88.8-140.8]) for the vastus lateralis (p<0.01), but not for the vastus medialis (120.8% [90.4-134.0]) and (121.8% [93.0-133.0]) (p = 0.17), respectively. Slow and rapid knee-extensions were performed at a median angular velocity of 19.7 degrees/sec (13.7-24.4) and 51.4 degrees/sec (28.9-63.1), respectively.

CONCLUSION

Four to eight weeks after their total knee arthroplasty, the patients in the present study were able to conduct rapid knee-extensions according to the experimental protocol with an approximately doubled angular velocity compared to slow knee-extensions. This was associated with increased muscle activity in the vastus lateralis when compared to slow knee-extensions, but not in the vastus medialis. Whether this significant, although relatively small, difference in vastus lateralis muscle activity has any clinical relevance needs further study.

LEVEL OF EVIDENCE

摘要

背景

全膝关节置换术后短期内（数周至数月），股四头肌抑制及膝关节伸展力量减弱较为常见，这是由于股四头肌的自主激活减少所致。在健康受试者中，已知进行大负荷力量训练可增加主动肌活动，尤其是当运动采用快速肌肉收缩方式时。

目的

本研究旨在探讨全膝关节置换术后4至8周的患者能否使用10次重复最大负荷（10 RM）进行快速膝关节伸展，以及与缓慢膝关节伸展相比，在实验性力量训练过程中快速膝关节伸展与更大的股四头肌自主活动相关的程度。

研究设计

一项随机交叉研究。

方法

24例全膝关节置换术后4 - 8周的患者（年龄66.5岁），使用其10次重复最大负荷，对患侧腿随机进行一组5次快速和一组5次缓慢膝关节伸展，同时从股四头肌的股内侧肌和股外侧肌获取表面肌电图记录。

结果

对纳入研究的24例患者中的23例数据进行分析。与缓慢膝关节伸展相比，股外侧肌在快速膝关节伸展时的肌肉活动显著更高（120.2% [第10 - 90百分位数：98.3 - 149.1]），而缓慢膝关节伸展时为（106.0% [88.8 - 140.8]）（p<0.01），但股内侧肌在快速（120.8% [90.4 - 134.0]）和缓慢（121.8% [93.0 - 133.0]）膝关节伸展时的肌肉活动分别无显著差异（p = 0.17）。缓慢和快速膝关节伸展的中位角速度分别为19.7度/秒（13.7 - 24.4）和51.4度/秒（28.9 - 63.1）。