Fahrer H, Rentsch H U, Gerber N J, Beyeler C, Hess C W, Grünig B
Department of Rheumatology, University of Bern, Inselspital, Switzerland.
J Bone Joint Surg Br. 1988 Aug;70(4):635-8. doi: 10.1302/0301-620X.70B4.3403614.
In order to investigate the difficulty of quadriceps training in the presence of an effusion into the knee we examined 13 patients with chronic effusions by recording isometric muscle strength. Maximal strength was markedly lower in the presence of an effusion, and aspiration of the effusion produced a 13.6% increase in strength (p less than 0.01). A further, small increase of 8% was recorded after intra-articular lignocaine injection. Isometric strength and surface integrated EMG correlated well in six patients. Two reflex mechanisms seem to inhibit quadriceps innervation in the presence of a persistent knee effusion, one mediated by pressure sensitive receptors, the other still unknown. Joint aspiration and systemic or intra-articular anti-inflammatory drug treatments are advised before any programme of quadriceps training to allow maximum effects to be achieved.
为了研究膝关节存在积液时股四头肌训练的难度，我们通过记录等长肌力对13例慢性积液患者进行了检查。存在积液时最大力量显著降低，抽出积液后力量增加了13.6%（p<0.01）。关节内注射利多卡因后又记录到了8%的小幅进一步增加。6例患者的等长肌力与表面积分肌电图相关性良好。在膝关节持续存在积液的情况下，似乎有两种反射机制抑制股四头肌的神经支配，一种由压力感受器介导，另一种尚不清楚。建议在进行任何股四头肌训练计划之前进行关节穿刺以及全身或关节内抗炎药物治疗，以实现最大效果。
