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改善内侧半月板部分损伤个体身体功能和肌肉表现的等速训练方案:一例报告

Isokinetic Training Program to Improve the Physical Function and Muscular Performance of an Individual with Partial Injury of the Medial Meniscus: A Case Report.

作者信息

Obara Karen, Silva Pedro, Silva Mariana, Mendes Fagner, Santiago Gabriel, Oliveira Ihan, Cardoso Jefferson

机构信息

Laboratory of Biomechanics and Clinical Epidemiology, PAIFIT Research Group Universidade Estadual de Londrina.

出版信息

Int J Sports Phys Ther. 2023 Jun 2;18(3):758-768. doi: 10.26603/001c.74945. eCollection 2023.

Abstract

BACKGROUND AND PURPOSE

One of the best alternatives for the treatment of meniscal injuries in relation to surgical procedures, is exercise. This case report aimed to describe the effects of isokinetic training and a neuromuscular/proprioceptive exercise program on muscle performance and physical function in an individual after a rupture of the posterior horn of the medial meniscus.

STUDY DESIGN

Case report.

CASE DESCRIPTION

A 40-year-old man injured his right knee during a soccer match, with a partial lesion of the medial meniscus confirmed by magnetic resonance imaging. He completed an isokinetic training program in addition to exercises that targeted proprioception (22 sessions, 11 weeks) to improve physical function and performance, which were assessed before and after treatment and at a six-month follow-up. An individual with similar anthropometric characteristics was chosen to be used as a control for understanding the patient's assessment values.

OUTCOMES

Muscular performance of the knee flexors and extensors was evaluated isokinetically using the Biodex System-4 in a concentric mode at angular velocities of 60, 120, and 300 °/s . The main results indicated that after 11 weeks, the peak torque normalized to body mass (PT/BM), at 60 °/s of the knee extensors remained unchanged (2.54 N.m/kg) (below the control value - 3.06 N.m/kg), and at the six-month follow-up, increased by approximately 20% (3.08 N.m/kg). For the hamstrings, at 60 °/s, an increase of 18 % occurred after intervention (1.98 N.m/kg) and by approximately 30 % at the six-month follow-up (2.12 N.m/kg) - values much higher than the control 1.55 N.m/kg). This increase in the PT/BM was also reflected in the Hamstrings:Quadriceps ratio (78 %) after treatment which improved at follow-up (68 %).

DISCUSSION

The results showed that the isokinetic training and neuromuscular/proprioceptive exercises improved the muscle performance of the knee flexors and extensors, after eleven weeks of intervention, and remained (or continued to improve) at the six-month follow-up.

LEVEL OF EVIDENCE

5, single case report.

摘要

背景与目的

在半月板损伤的手术治疗方面,最佳替代方案之一是运动锻炼。本病例报告旨在描述等速训练和神经肌肉/本体感觉训练计划对一名内侧半月板后角撕裂患者肌肉功能和身体功能的影响。

研究设计

病例报告。

病例描述

一名40岁男性在一场足球比赛中右膝受伤,磁共振成像证实为内侧半月板部分损伤。他除了完成针对本体感觉的训练(22节训练课,为期11周)外,还完成了一项等速训练计划,以改善身体功能和表现,在治疗前后及六个月随访时对其进行评估。选择一名具有相似人体测量特征的个体作为对照,以了解患者的评估值。

结果

使用Biodex System-4等速测试仪以60、120和300°/秒的角速度在向心模式下对等速膝关节屈伸肌的肌肉功能进行评估。主要结果表明,11周后,膝关节伸肌在60°/秒时归一化至体重的峰值扭矩(PT/BM)保持不变(2.54 N.m/kg)(低于对照值3.06 N.m/kg),在六个月随访时增加了约20%(3.08 N.m/kg)。对于腘绳肌,在60°/秒时,干预后增加了18%(1.98 N.m/kg),在六个月随访时增加了约30%(2.12 N.m/kg)——该值远高于对照值1.55 N.m/kg)。PT/BM的增加也反映在治疗后腘绳肌与股四头肌的比例(78%)上,随访时有所改善(68%)。

讨论

结果表明,经过11周的干预,等速训练和神经肌肉/本体感觉训练改善了膝关节屈伸肌的肌肉功能,并在六个月随访时保持(或持续改善)。

证据级别

5级,单病例报告。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d04b/10449488/71a48b21d5f1/ijspt_2023_18_3_74945_158204.jpg

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