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全髋关节置换术前及术后6个月的爆发力和最大力量。

Explosive and maximal strength before and 6 months after total hip arthroplasty.

作者信息

Friesenbichler Bernd, Casartelli Nicola C, Wellauer Vanessa, Item-Glatthorn Julia F, Ferguson Stephen J, Leunig Michael, Maffiuletti Nicola A

机构信息

Human Performance Lab, Schulthess Clinic, Lengghalde 2, 8008 Zurich, Switzerland.

Laboratory of Exercise and Health, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.

出版信息

J Orthop Res. 2018 Jan;36(1):425-431. doi: 10.1002/jor.23626. Epub 2017 Jun 26.

Abstract

Patients with unilateral hip osteoarthritis experience impairments in lower limb muscle function due to pain and disuse of the affected limb. The influence of hip osteoarthritis and subsequent total hip arthroplasty (THA) has mostly been evaluated by maximal strength tests, yet the functionally important explosive strength capabilities of hip and knee muscles are largely unknown. We aimed to evaluate hip and knee explosive and maximal strength in hip osteoarthritis patients before and after THA. Twenty-one patients with unilateral hip osteoarthritis were evaluated before and 6 months after THA. They performed rapid maximal contractions of hip (flexor, extensor, abductor, adductor) and knee (flexor, extensor) muscles, from which explosive and maximal strength asymmetries were evaluated (involved versus uninvolved limb). Before THA, the involved limb showed significantly lower hip flexor, extensor, adductor, and knee extensor explosive and maximal strength compared to the uninvolved limb. Six months after THA surgery, hip flexor, extensor and adductor maximal and explosive strength asymmetries persisted, except for knee extensors. Explosive, but not maximal strength of hip abductors and knee extensors was lower in the involved limb before surgery and the reduced explosive strength capabilities may compromise daily living activities in hip osteoarthritis patients. After hip replacement, explosive strength asymmetries of knee extensors resolved, yet lingering asymmetries in hip flexor muscles should receive focused attention during postoperative rehabilitation. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:425-431, 2018.

摘要

单侧髋关节骨关节炎患者因患侧肢体疼痛和废用而出现下肢肌肉功能受损。髋关节骨关节炎及其后续全髋关节置换术(THA)的影响大多通过最大力量测试来评估,然而,髋部和膝部肌肉在功能上重要的爆发力能力在很大程度上尚不清楚。我们旨在评估THA前后髋关节骨关节炎患者的髋部和膝部爆发力及最大力量。对21名单侧髋关节骨关节炎患者在THA术前及术后6个月进行评估。他们进行了髋部(屈肌、伸肌、外展肌、内收肌)和膝部(屈肌、伸肌)肌肉的快速最大收缩,据此评估爆发力和最大力量的不对称性(患侧与未患侧肢体)。在THA术前,与未患侧肢体相比,患侧肢体的髋部屈肌、伸肌、内收肌以及膝部伸肌的爆发力和最大力量明显更低。THA手术后6个月,除膝部伸肌外,髋部屈肌、伸肌和内收肌的最大力量和爆发力不对称性依然存在。术前患侧肢体髋部外展肌和膝部伸肌的爆发力(而非最大力量)较低,爆发力能力降低可能会影响髋关节骨关节炎患者的日常生活活动。髋关节置换术后,膝部伸肌的爆发力不对称性得到解决,但髋部屈肌持续存在的不对称性在术后康复期间应受到重点关注。© 2017骨科学研究协会。由威利期刊公司出版。《矫形外科学研究》36:425 - 431, 2018年。

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