中医正骨2025，Vol.37Issue(12)：1-7,7.
髋外展肌等速训练联合理筋整复手法治疗膝骨关节炎的临床研究
A clinical study of hip abductor isokinetic training combined with tendon rectification manipulation for treat-ment of knee osteoarthritis
摘要
Abstract
Objective:To evaluate the clinical efficacy and safety of hip abductor isokinetic training combined with tendon rectification manipulation in treatment of knee osteoarthritis(KOA).Methods:Eighty-four KOA patients,recruited from August 2024 to May 2025,were enrolled in the study,and randomized into manipulation group and combination group,with 42 ones in each group.All patients in the 2 groups were instructed to perform quadriceps training,then,the ones in the manipulation group were further treated with tendon rectifica-tion manipulation,and the ones in the combination group with hip abductor isokinetic training,except for the tendon rectification manipula-tion.All interventions were performed once every other day for consecutive 6 weeks.After that,the affected knee Western Ontario and Mc-Master Universities osteoarthritis index(WOMAC)score,pain visual analogue scale(VAS)score,range of motion(ROM),relative peak torque of the hip abductors,and time to peak torque of the quadriceps were measured before and after the treatment,and the complications were monitored throughout the trial.Results:①General information.One patient was lost to follow-up in the combination group,and 83 ca-ses were included in the final analysis.②WOMAC score.The WOMAC score showed no significant difference between the 2 groups before the treatment,while it decreased in the 2 groups after the end of the treatment compared to pre-treatment(33.32±5.36 vs 20.41±3.94 points,t=35.584,P=0.000;35.24±5.21 vs 26.43±4.44 points,t=40.254,P=0.000),with the lower values observed in the combination group(t=6.523,P=0.000).③Affected knee pain VAS score.The knee pain VAS score showed no significant difference be-tween the 2 groups before the treatment,but it decreased in the 2 groups after the end of the treatment compared to pre-treatment(5.88±1.45 vs 2.41±1.52 points,t=15.861,P=0.000;5.74±1.42 vs 3.02±1.24 points,t=12.872,P=0.000),with the lower values ob-served in the combination group(t=2.006,P=0.048).④Affected knee ROM.The knee ROM showed no significant difference between the 2 groups before the treatment,but it increased in the 2 groups after the end of the treatment compared to pre-treatment(106.50±4.47 vs 119.43±4.25 degrees,t=-57.537,P=0.000;107.41±4.59 vs 114.93±4.60 degrees,t=-33.969,P=0.000),with a greater increase observed in the combination group(t=-4.616,P=0.000).⑤Relative peak torque of the hip abductors.The relative peak torque of the hip abductors showed no significant difference between the 2 groups before the treatment,while,it merely increased in the combina-tion group after the end of the treatment compared to pre-treatment(0.96±0.10 vs 1.02±0.09 Nm/kg,t=-20.695,P=0.000),but not different in manipulation group between pre-treatment and post-treatment,with the greater values observed in the combination group(t=-2.707,P=0.008).⑥Time to peak torque of the quadriceps.The time to peak torque of the quadriceps showed no significant differ-ence between the 2 groups before the treatment,but it shortened in the 2 groups after the end of the treatment compared to pre-treatment(603.00±25.86 vs 383.88±26.67 milliseconds,t=283.406,P=0.000;596.98±24.25 vs 491.29±25.98 milliseconds,t=117.936,P=0.000),with a more pronounced shortening observed in the combination group(t=18.586,P=0.000).⑦Complications.Throughout the trial,3 patients in the combination group and 2 ones in the manipulation group experienced mild muscle soreness and distension,which resolved spontaneously after rest and relaxation.Conclusion:Combination of hip abductor isokinetic training with tendon rectification ma-nipulation can enhance the strength of hip abductor and activate the quadriceps,thereby effectively alleviating the knee pain,increasing the knee ROM,and improving the knee function.Its therapeutic efficacy is superior to that of performing tendon rectification manipulation alone,with a comparable safety profile.关键词
骨关节炎,膝/运动疗法/髋外展肌/股四头肌/等速运动/理筋手法/整复疗法/随机对照试验专题Key words
osteoarthritis,knee/exercise therapy/hip abductor/quadriceps femoris muscle/isokinetic exercise/therapeutic manipulation for injured soft tissue/reduction therapy/randomized controlled trials as topic引用本文复制引用
周凌峰,毛娇,郑晓,汤雨婷,孙阳,李岩峰,张盛禹,徐轶飞,陆丽源,朱颖慧..髋外展肌等速训练联合理筋整复手法治疗膝骨关节炎的临床研究[J].中医正骨,2025,37(12):1-7,7.基金项目
上海市卫生健康委员会科研项目(20234Y0140) （20234Y0140）
