Muscle Deficits Persist After Unilateral Knee Replacement and Have Implications for Rehabilitation
Muscle Deficits Persist After Unilateral Knee Replacement and Have Implications for Rehabilitation
复制标题
单侧膝关节置换术后肌肉缺陷仍然存在，对康复有影响
作者：
A. Valtonen;T. Pöyhönen;A. Heinonen;S. Sipilä
背景：膝关节关节炎会引起疼痛、活动范围减少和活动受限。膝关节置换术能有效减轻疼痛。然而，膝关节置换患者患侧腿部肌肉力量(“力量产生能力”)下降，行走和其他体力活动有困难。目的和设计：这项横断面研究的目的是确定膝关节置换术后膝关节伸肌和屈肌扭矩和功率(随时间工作的能力)和伸肌横截面积(CSA)的缺陷程度。此外，还研究了小腿肌肉缺陷与活动受限的关系。方法：研究对象为29名女性和19名男性，年龄在55岁到75岁之间，平均10个月前曾接受过单侧膝关节置换手术。用等速测力仪测量膝关节伸肌和屈肌的最大扭矩和最大功率。用CT测量膝关节伸肌的CSA。计算接受置换手术的膝关节(“手术膝关节”)和未接受置换手术的膝关节(“非手术膝关节”)之间的对称性赤字。测定最大步行速度和上下楼梯时间。结果：膝关节伸屈肌力矩和功率平均缺失13%~27%，伸肌CSA平均缺失14%。伸膝力量的较大不足预示着爬楼梯和下楼梯的时间会更慢。当考虑到非手术侧的力量和潜在的混杂因素时，这种关系保持不变。局限性：研究样本由相对健康和活动能力较强的人组成。一些参与者在未手术的膝盖患上了骨性关节炎。结论：膝关节置换术后10个月出现了肌肉扭矩和功率以及伸肌CsA的缺陷，可能导致行走楼梯受限。为了防止活动受限和残疾，在膝关节置换后的康复过程中应该考虑到下肢力量的不足。
Background: Knee joint arthritis causes pain, decreased range of motion, and mobility limitation. Knee replacement reduces pain effectively. However, people with knee replacement have decreases in muscle strength (“force-generating capacity”) of the involved leg and difficulties with walking and other physical activities. Objective and Design: The aim of this cross-sectional study was to determine the extent of deficits in knee extensor and flexor muscle torque and power (ability to perform work over time) and in the extensor muscle cross-sectional area (CSA) after knee joint replacement. In addition, the association of lower-leg muscle deficits with mobility limitations was investigated. Methods: Participants were 29 women and 19 men who were 55 to 75 years old and had undergone unilateral knee replacement surgery an average of 10 months earlier. The maximal torque and power of the knee extensor and flexor muscles were measured with an isokinetic dynamometer. The knee extensor muscle CSA was measured with computed tomography. The symmetry deficit between the knee that underwent replacement surgery (“operated knee”) and the knee that did not undergo replacement surgery (“nonoperated knee”) was calculated. Maximal walking speed and stair-ascending and stair-descending times were assessed. Results: The mean deficits in knee extensor and flexor muscle torque and power were between 13% and 27%, and the mean deficit in the extensor muscle CSA was 14%. A larger deficit in knee extension power predicted slower stair-ascending and stair-descending times. This relationship remained unchanged when the power of the nonoperated side and the potential confounding factors were taken into account. Limitations: The study sample consisted of people who were relatively healthy and mobile. Some participants had osteoarthritis in the nonoperated knee. Conclusions: Deficits in muscle torque and power and in the extensor muscle CSA were present 10 months after knee replacement, potentially causing limitations in negotiating stairs. To prevent mobility limitations and disability, deficits in lower-limb power should be considered during rehabilitation after knee replacement.
通过生物力学预防跌倒和跌倒相关骨折。
DOI：
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发表时间：
2000
期刊：
Exercise and sport sciences reviews.
影响因子：
--
作者：
Robinovitch,SN;Hsiao,ET;Sandler,R;Cortez,J;Liu,Q;Paiement,GD
通讯作者：
Paiement,GD
DOI：
10.2519/jospt.2005.35.7.424
发表时间：
2005-07-01
影响因子：
6.1
作者：
Mizner, RL;Petterson, SC;Snyder-Mackler, L
通讯作者：
Snyder-Mackler, L