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[1]張琥,張旻,龔幼波,等.太極拳對(duì)早期膝骨關(guān)節(jié)炎患者步態(tài)影響的研究[J].中醫(yī)正骨,2018,30(09):34-38.
　ZHANG Hu,ZHANG Min,GONG Youbo,et al.Effects of shadow boxing on gait of patients with early knee osteoarthritis:a clinical study[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(09):34-38.
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太極拳對(duì)早期膝骨關(guān)節(jié)炎患者步態(tài)影響的研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第30卷
期數(shù):
2018年09期
頁碼:
34-38
欄目:
骨關(guān)節(jié)炎
出版日期:
2018-09-20

文章信息/Info

Title:
Effects of shadow boxing on gait of patients with early knee osteoarthritis:a clinical study
作者:
張琥; 張旻; 龔幼波; 談繹文; 高寧陽; 顧新豐; 鄭昱新; 詹紅生
上海中醫(yī)藥大學(xué)附屬曙光醫(yī)院,上海 201203
Author(s):
ZHANG Hu; ZHANG Min; GONG Youbo; TAN Yiwen; GAO Ningyang; GU Xinfeng; ZHENG Yuxin; ZHAN Hongsheng
Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China
關(guān)鍵詞:
骨關(guān)節(jié)炎; 膝;  步態(tài);  太極拳;  生物力學(xué);  臨床試驗(yàn)
Keywords:
osteoarthritis; knee;  gait;  shadow boxing;  biomechanics;  clinical trial
摘要:
觀察太極拳對(duì)早期膝骨關(guān)節(jié)炎(knee osteoarthritis,KOA)患者步態(tài)的影響,并探討其作用機(jī)理。方法:將68例早期KOA患者隨機(jī)分為2組,每組34例,分別進(jìn)行太極拳鍛煉(太極拳鍛煉組)和仰臥位下肢模擬騎自行車鍛煉(自行車鍛煉組),共鍛煉12周。治療前后采用三維步態(tài)捕捉分析系統(tǒng)采集患者的步長(zhǎng)、步速及髖、膝關(guān)節(jié)內(nèi)收力矩峰值。結(jié)果:至研究結(jié)束時(shí),太極拳鍛煉組1例脫落、自行車鍛煉組2例脫落,均未說明原因不再來院治療。治療前2組患者的步長(zhǎng)、步速比較,組間差異均無統(tǒng)計(jì)學(xué)意義(t=0.706,P=0.482; t=-0.584,P=0.561); 治療結(jié)束后2組患者的步長(zhǎng)、步速均增加[(0.50±0.06)m,(0.58±0.03)m,t=-9.900,P=0.000;(0.49±0.05)m,(0.52±0.04)m,t=-6.316,P=0.000;(0.94±0.04)m·s-1,(1.04±0.06)m·s-1,t=-8.810,P=0.000;(0.94±0.05)m·s-1,(0.99±0.04)m·s-1,t=-9.259,P=0.000],太極拳鍛煉組的步長(zhǎng)、步速均大于自行車鍛煉組(t=7.399,P=0.000; t=3.774,P=0.000)。治療前2組患者的髖關(guān)節(jié)內(nèi)收力矩峰值比較,差異無統(tǒng)計(jì)學(xué)意義(t=-0.169,P=0.867); 治療結(jié)束后太極拳鍛煉組的髖關(guān)節(jié)內(nèi)收力矩峰值增大[(0.60±0.10)Nm,(0.66±0.08)Nm,t=-6.124,P=0.000],自行車鍛煉組的髖關(guān)節(jié)內(nèi)收力矩峰值與治療前比較差異無統(tǒng)計(jì)學(xué)意義[(0.60±0.10)Nm,(0.61±0.10)Nm,t=-1.359,P=0.184]; 治療結(jié)束后太極拳鍛煉組的髖關(guān)節(jié)內(nèi)收力矩峰值大于自行車鍛煉組(t=2.429,P=0.018)。治療前2組患者的膝關(guān)節(jié)內(nèi)收力矩峰值比較,差異無統(tǒng)計(jì)學(xué)意義(t=0.422,P=0.674); 治療結(jié)束后太極拳鍛煉組的膝關(guān)節(jié)內(nèi)收力矩峰值減小[(0.28±0.09)Nm,(0.27±0.08)Nm,t=2.547,P=0.016],自行車鍛煉組的膝關(guān)節(jié)內(nèi)收力矩峰值與治療前比較差異無統(tǒng)計(jì)學(xué)意義[(0.27±0.09)Nm,(0.27±0.08)Nm,t=-0.258,P=0.798]; 治療結(jié)束后2組患者膝關(guān)節(jié)內(nèi)收力矩峰值比較,差異無統(tǒng)計(jì)學(xué)意義(t=-0.261,P=0.795)。結(jié)論:太極拳鍛煉和仰臥位下肢模擬騎自行車鍛煉均能增加早期KOA患者的步長(zhǎng)和步速,但太極拳鍛煉的效果更好,其作用機(jī)制可能是通過鍛煉增大髖關(guān)節(jié)內(nèi)收力矩或限制其減小,降低膝關(guān)節(jié)內(nèi)收力矩或限制其增大。
Abstract:
To observe the effects of shadow boxing on gait of patients with early knee osteoarthritis(KOA)and to explore its mechanism of action.Methods:Sixty-eight patients with early KOA were randomly divided into 2 groups,34 cases in each group,and were treated with shadow boxing exercise(shadow boxing group)and analogic bicycle exercise with lower limbs in supine position(bicycle group)respectively for consecutive 12 weeks.The patient's step length,gait speed and peak adduction torque of hip joint and knee joint were measured by using three-dimensional gait capturing-analyzing system before and after treatment respectively.Results:One patient in shadow boxing group and 2 patients in bicycle group dropped out of the treatment without any explanation.There was no statistical difference in step length and gait speed between the 2 groups before the treatment(t=0.706,P=0.482; t=-0.584,P=0.561).The step length and gait speed increased after the end of the treatment compared to pretreatment in the 2 groups(0.50+/-0.06 vs 0.58+/-0.03 m,t=-9.900,P=0.000; 0.49+/-0.05 vs 0.52+/-0.04 m,t=-6.316,P=0.000; 0.94+/-0.04 vs 1.04+/-0.06 m/s,t=-8.810,P=0.000; 0.94+/-0.05 vs 0.99+/-0.04 m/s,t=-9.259,P=0.000),and the step length and gait speed were greater in shadow boxing group compared to bicycle group(t=7.399,P=0.000; t=3.774,P=0.000).There was no statistical difference in the peak adduction torque of hip joint between the 2 groups before the treatment(t=-0.169,P=0.867).The peak adduction torque of hip joint increased after the end of the treatment compared to pretreatment in shadow boxing group(0.60+/-0.10 vs 0.66+/-0.08 Nm,t=-6.124,P=0.000),and there was no statistical difference in the peak adduction torque of hip joint between pre-treatment and post-treatment in bicycle group(0.60+/-0.10 vs 0.61+/-0.10 Nm,t=-1.359,P=0.184).The peak adduction torque of hip joint was greater in shadow boxing group compared to bicycle group after the end of the treatment(t=2.429,P=0.018).There was no statistical difference in the peak adduction torque of knee joint between the 2 groups before the treatment(t=0.422,P=0.674).The peak adduction torque of knee joint decreased after the end of the treatment compared to pretreatment in shadow boxing group(0.28+/-0.09 vs 0.27+/-0.08 Nm,t=2.547,P=0.016),and there was no statistical difference in the peak adduction torque of knee joint between pre-treatment and post-treatment in bicycle group(0.27+/-0.09 vs 0.27+/-0.08 Nm,t=-0.258,P=0.798).There was no statistical difference in the peak adduction torque of knee joint between the 2 groups after the end of the treatment(t=-0.261,P=0.795).Conclusion:Both shadow boxing exercise and analogic bicycle exercise with lower limbs in supine position can increase step length and gait speed of patients with early KOA,and the former has more significant effect.The shadow boxing exercise can decrease the adduction torque of knee joint or limit its increase and increase the adduction torque of hip joint or limit its decrease,which may be its mechanism of action.

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備注/Memo

備注/Memo:
基金項(xiàng)目:上海市中醫(yī)藥領(lǐng)軍人才建設(shè)學(xué)術(shù)共同體成員培養(yǎng)項(xiàng)目(ZY3-RCPY-1-1001); “中醫(yī)骨傷科學(xué)”國(guó)家重點(diǎn)學(xué)科建設(shè)項(xiàng)目(100508); 上海市名老中醫(yī)藥專家學(xué)術(shù)經(jīng)驗(yàn)研究工作室建設(shè)項(xiàng)目(SHGZS-2017025); 上海市重中之重臨床醫(yī)學(xué)和重點(diǎn)學(xué)科建設(shè)項(xiàng)目(2017ZZ02024) 通訊作者:詹紅生 E-mail:[email protected]
更新日期/Last Update: 2018-09-20