Burgess Louise C, Taylor Paul, Wainwright Thomas W, Swain Ian D
Orthopaedic Research Institute, Bournemouth University, Bournemouth, UK.
Department of Clinical Science and Engineering, Salisbury District Hospital, Salisbury, UK.
Disabil Rehabil. 2022 Sep;44(19):5563-5570. doi: 10.1080/09638288.2021.1939797. Epub 2021 Jun 22.
This study compares lower limb muscle strength and endurance in adults with hip osteoarthritis, to an age-matched control group.
Thirteen adults with moderate-to-severe hip osteoarthritis (as graded by the Oxford Hip Score) and fifteen older adults participated. Maximal voluntary isometric contraction of the knee extensors, knee flexors and hip abductors and isotonic endurance of the knee extensors were measured using a dynamometer. Function was assessed using the 30-second chair stand test, the 40 m fast-paced walk test and a stair negotiation test. Data were compared between groups using -tests.
Participants with hip osteoarthritis demonstrated weakness in the affected limb when compared to the control limb during knee flexion (34%, = 0.004) and hip abduction (46%, = 0.001). Weakness was also observed in the contralateral knee flexors (31%, = 0.01). When compared to the control limb, the knee extensors of the hip osteoarthritis group were exhausted prematurely in the affected (70%, = 0.001) and contralateral limb (62%, = 0.005). The hip osteoarthritis group took twice as long to stair climb ( = 0.002), walked 40% slower, ( < 0.001), and had a 35% lower sit-stand performance ( < 0.001).
Moderate-to-severe hip osteoarthritis may be characterised by bilateral deficits in lower-limb maximal strength, markedly lower knee extensor endurance and impaired functional performance.Implications for rehabilitationIn addition to bilateral deficits in maximal strength of the hip and knee muscles, moderate-to-severe hip osteoarthritis may be characterised by markedly lower muscular endurance of the knee extensors and impaired functional performance.The endurance capacity of the knee extensors can play an important role in daily function, and thus it is important to consider endurance training principles when prescribing exercise for this patient group.Research studies evaluating exercise programmes underpinned by endurance training principles are required to understand the benefits to patients with hip osteoarthritis, and to inform specific exercise prescription in clinical practice.
本研究将患有髋骨关节炎的成年人的下肢肌肉力量和耐力与年龄匹配的对照组进行比较。
13名患有中度至重度髋骨关节炎(根据牛津髋关节评分分级)的成年人和15名老年人参与了研究。使用测力计测量膝关节伸肌、膝关节屈肌和髋关节外展肌的最大自主等长收缩以及膝关节伸肌的等张耐力。使用30秒坐立试验、40米快步行走试验和上楼梯试验评估功能。使用t检验对两组数据进行比较。
与对照组相比,患有髋骨关节炎的参与者在膝关节屈曲(34%,P = 0.004)和髋关节外展(46%,P = 0.001)时,患侧肢体表现出无力。在对侧膝关节屈肌中也观察到无力(31%,P = 0.01)。与对照组相比,髋骨关节炎组的膝关节伸肌在患侧(70%,P = 0.001)和对侧肢体(62%,P = 0.005)中过早疲劳。髋骨关节炎组爬楼梯的时间是对照组的两倍(P = 0.002),步行速度慢40%(P < 0.001),坐立表现低35%(P < 0.001)。
中度至重度髋骨关节炎的特征可能是下肢最大力量的双侧缺陷、膝关节伸肌耐力明显降低以及功能表现受损。
康复意义
除了髋部和膝部肌肉最大力量的双侧缺陷外,中度至重度髋骨关节炎的特征可能是膝关节伸肌的肌肉耐力明显降低以及功能表现受损。膝关节伸肌的耐力能力在日常功能中可以发挥重要作用,因此在为该患者群体开运动处方时考虑耐力训练原则很重要。
需要进行评估以耐力训练原则为基础的运动计划的研究,以了解对髋骨关节炎患者的益处,并为临床实践中的具体运动处方提供依据。