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股四头肌扭矩发展率与膝骨关节炎患者的残疾。

Quadriceps Rate of Torque Development and Disability in Persons With Tibiofemoral Osteoarthritis.

出版信息

J Orthop Sports Phys Ther. 2018 Sep;48(9):694-703. doi: 10.2519/jospt.2018.7898. Epub 2018 May 22.

Abstract

Background Declines in the ability to rapidly generate quadriceps muscle torque may underlie disability in individuals with tibiofemoral osteoarthritis. Objective To determine whether quadriceps rate of torque development (RTD) predicts self-reported disability and physical performance outcomes in individuals with tibiofemoral osteoarthritis. Methods This controlled laboratory, cross-sectional study assessed quadriceps strength and RTD in 76 individuals (55% female; mean ± SD age, 61.83 ± 7.11 years) with symptomatic and radiographic tibiofemoral osteoarthritis. Early (0-50 milliseconds), late (100-200 milliseconds), and overall peak RTDs were quantified in the symptomatic (involved) and contralateral limbs and used to calculate bilateral average values. Disability was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) function subscale and 3 physical performance tests, including the (1) 20-m fast-paced walk, (2) 30-second chair stand, and (3) timed stair climb. Separate univariate regression models were used to determine the unique associations among measures of quadriceps RTD, WOMAC function score, and physical performance outcomes after accounting for quadriceps strength (change in R). Results Greater involved-side late RTD and greater bilateral average early RTD were associated with faster walking (change in R = 0.05, P = .013 and change in R = 0.05, P = .043, respectively). Greater bilateral average late RTD was associated with faster walking (change in R = 0.20, P<.001) and faster stair climb (change in R = 0.11, P = .001). No quadriceps RTD variable was significantly associated with WOMAC function score (change in R range, <0.01-0.017). Conclusion Involved-limb quadriceps RTD was weakly associated with physical performance outcomes, but not self-reported disability, in individuals with tibiofemoral osteoarthritis. Bilateral average quadriceps RTD was moderately associated with walking speed. Level of Evidence Prognosis, level 2b. J Orthop Sports Phys Ther 2018;48(9):694-703. Epub 22 May 2018. doi:10.2519/jospt.2018.7898.

摘要

背景

股四头肌快速产生扭矩能力的下降可能是导致膝骨关节炎患者丧失活动能力的原因。目的:确定股四头肌扭矩发展速率(RTD)是否可以预测膝骨关节炎患者的自报告残疾和身体表现结果。

方法

本对照实验室横断面研究评估了 76 名有症状和放射照相性膝骨关节炎患者(55%为女性;平均年龄±标准差为 61.83±7.11 岁)的股四头肌力量和 RTD。在症状(受累)和对侧肢体中量化了早期(0-50 毫秒)、晚期(100-200 毫秒)和总体峰值 RTD,并计算了双侧平均值。使用 Western Ontario 和 McMaster 大学骨关节炎指数(WOMAC)功能量表和 3 项身体表现测试(包括 1)20 米快速行走、2)30 秒坐立起身和 3)计时爬楼梯)评估残疾。分别使用单变量回归模型,在考虑股四头肌强度(R 变化)的情况下,确定股四头肌 RTD、WOMAC 功能评分和身体表现结果之间的独特关联。

结果

较大的受累侧晚期 RTD 和较大的双侧平均早期 RTD 与更快的行走速度相关(R 变化分别为 0.05,P=0.013 和 0.05,P=0.043)。较大的双侧平均晚期 RTD 与更快的行走(R 变化为 0.20,P<0.001)和更快的爬楼梯(R 变化为 0.11,P=0.001)相关。股四头肌 RTD 的任何变量都与 WOMAC 功能评分(R 变化范围,<0.01-0.017)无显著相关性。

结论

在膝骨关节炎患者中,受累肢体的股四头肌 RTD 与身体表现结果呈弱相关,但与自报告残疾无关。双侧平均股四头肌 RTD 与行走速度中度相关。

证据水平

预后,2b 级。

美国骨科物理治疗杂志 2018 年;48(9):694-703。2018 年 5 月 22 日电子出版。doi:10.2519/jospt.2018.7898.

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