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绝经后膝骨关节炎女性在低至中等速度下膝关节伸肌扭矩产生减少。

Reduced knee extensor torque production at low to moderate velocities in postmenopausal women with knee osteoarthritis.

机构信息

GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain.

CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain.

出版信息

Scand J Med Sci Sports. 2021 Nov;31(11):2144-2155. doi: 10.1111/sms.14035. Epub 2021 Aug 25.

Abstract

This study aimed to determine deficits in knee extensor muscle function through the torque-time and torque-velocity relationships and whether these deficits are associated with reduced functional performance in postmenopausal women with knee osteoarthritis (KOA). A clinical sample of postmenopausal women with established KOA (n = 18, ≥55 years) was compared to an age-matched healthy control sample (CON) (n = 26). The deficits in different parameters of the knee extensor torque-time (maximal isometric torque and rate of torque development) and torque-velocity relationship (maximum muscle power, maximal velocity and torque at 0-500°·s ) were assessed through a protocol consisting of isometric, isotonic and isokinetic tests. Functional performance was evaluated with sit-to-stand and stair-climbing tasks using a sensor-based technology (ie, time- and power-based outcomes). Postmenopausal women with KOA showed reduced maximal isometric torque (Hedge's g effect size (g) = 1.05, p = 0.001) and rate of torque development (g = 0.77-1.17, all p ≤ 0.02), combined with impaired torque production at slow to moderate velocities (g = 0.92-1.70, p ≤ 0.004), but not at high or maximal velocities (g = 0.16, p > 0.05). KOA were slower (g = 0.81-0.92, p ≤ 0.011) and less powerful (g = 1.11-1.29, p ≤ 0.001) during functional tasks. Additionally, knee extensor deficits were moderately associated with power deficits in stair climbing (r = 0.492-0.659). To conclude, knee extensor muscle weakness was presented in postmenopausal women with KOA, not only as limited maximal and rapid torque development during isometric contractions, but also dynamically at low to moderate velocities. These deficits were related to impaired functional performance. The assessment of knee extensor muscle weakness through the torque-time and torque-velocity relationships might enable individual targets for tailored exercise interventions in KOA.

摘要

本研究旨在通过力矩-时间和力矩-速度关系来确定膝关节伸肌功能的缺陷,以及这些缺陷是否与绝经后膝骨关节炎(KOA)女性的功能表现下降有关。将患有 KOA 的绝经后女性的临床样本(n=18,年龄≥55 岁)与年龄匹配的健康对照组(CON)(n=26)进行比较。通过包括等长、等速和等动测试的方案来评估膝关节伸肌力矩-时间(最大等长扭矩和力矩发展率)和力矩-速度关系(最大肌肉力量、最大速度和 0-500°·s 时的扭矩)的不同参数的缺陷。使用基于传感器的技术(即基于时间和功率的结果)评估坐站和爬楼梯任务的功能表现。KOA 绝经后女性的最大等长扭矩降低(Hedge's g 效应大小(g)=1.05,p=0.001)和力矩发展率降低(g=0.77-1.17,均 p≤0.02),同时在较慢至中等速度下的扭矩产生受损(g=0.92-1.70,p≤0.004),但在高速或最大速度下不受损(g=0.16,p>0.05)。KOA 在功能任务中较慢(g=0.81-0.92,p≤0.011)和功率较低(g=1.11-1.29,p≤0.001)。此外,膝关节伸肌缺陷与爬楼梯时的功率缺陷中度相关(r=0.492-0.659)。总之,KOA 绝经后女性存在膝关节伸肌肌无力,不仅在等长收缩时表现为最大和快速扭矩发展受限,而且在低至中等速度下也表现为动态受限。这些缺陷与功能表现受损有关。通过力矩-时间和力矩-速度关系评估膝关节伸肌肌无力可能为 KOA 的个体化运动干预提供目标。

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