[1]张旻 陈博 潘富伟 李正言 陆洁航 詹红生△.太极拳对早期膝骨关节炎患者膝关节内侧间室应力的影响[J].中国中医骨伤科杂志,2022,30(04):5-9.
　ZHANG Min CHEN Bo PAN Fuwei LI Zhengyan LU Jiehang ZHAN Hongsheng.Efficacy of Tai Chi Exercise on Loading in the Medial Compartment of the Knee in Individuals with Early Stage of Knee Osteoarthritis[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2022,30(04):5-9.
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太极拳对早期膝骨关节炎患者膝关节内侧间室应力的影响()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第30卷
期数:
2022年04期
页码:
5-9
栏目:
临床研究
出版日期:
2022-04-15

文章信息/Info

Title:
Efficacy of Tai Chi Exercise on Loading in the Medial Compartment of the Knee in Individuals with Early Stage of Knee Osteoarthritis
文章编号:
1005-0205(2022)04-0005-05
作者:
张旻1; 2 陈博1; 2 潘富伟1; 2 李正言1; 2 陆洁航1; 2 詹红生1; 2△
1上海中医药研究院骨伤科研究所(上海,201203)2上海中医药大学附属曙光医院骨伤科研究所
Author(s):
ZHANG Min1; 2 CHEN Bo1; 2 PAN Fuwei1; 2 LI Zhengyan1; 2 LU Jiehang1; 2 ZHAN Hongsheng1; 2△
1Institute of Traumatology & Orthopedics,Shanghai Academy of Traditional Chinese Medicine,Shanghai 201203,China; 2Institute of Orthopedics and Traumatology,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China.
关键词:
太极拳; 膝骨关节炎; 膝关节应力; 运动学; 动力学
Keywords:
Tai Chi;  knee osteoarthritis;  knee loading;  kinematics;  kinetics
分类号:
R684.3
文献标志码:
A
摘要:
目的:研究太极拳不同动作时脚步移动对早期膝骨关节炎(KOA)患者膝关节内侧间室应力的影响。方法:利用三维动作分析系统配合三维测力台,比较2020年6月至2020年12月就诊的21名早期膝骨关节炎患者,在自然行走、太极拳动作搂膝拗步与倒卷肱三种条件下,膝关节支撑相早期膝关节最大屈膝角度,支撑相时膝关节最大内翻角度,支撑相时最大下肢前进角度,膝关节屈力矩,膝关节内收力矩,踝关节外翻力矩,以及地面反作用力内侧分力。结果:相较于自然行走,KOA患者在进行太极拳搂膝拗步及倒卷肱练习时支撑相早期膝关节最大屈曲角度,支撑相时下肢前进角度均显著增加,差异有统计学意义(P<0.05)。此外,搂膝拗步时支撑相早期最大屈膝角度及下肢前进角度均显著大于倒卷肱,差异有统计学意义(P<0.05)。相较于自然行走及倒卷肱,搂膝拗步时膝关节内翻角度显著降低,而倒卷肱时膝关节内翻角度显著高于自然行走,差异有统计学意义(P<0.05)。搂膝拗步时膝关节最大屈力矩显著高于自然行走及倒卷肱,差异有统计学意义(P<0.05),而倒卷肱与自然行走时膝关节屈力矩差异无统计学意义(P>0.05)。相较于自然行走,搂膝拗步及倒卷肱练习时膝关节内收力矩显著降低,差异有统计学意义(P<0.05),而搂膝拗步及倒卷肱膝关节内收力矩差异无统计学意义(P>0.05)。踝关节外翻力矩差异无统计学意义(P>0.05)。倒卷肱时地面反作用力内侧方向较自然行走及搂膝拗步时显著降低,差异有统计学意义(P<0.05),而自然行走及搂膝拗步时地面反作用力内侧方向差异无统计学意义(P>0.05)。结论:太极拳搂膝拗步及倒卷肱动作练习时膝关节内侧间室应力均较自然行走时显著降低,然而由于过高的膝关节屈膝角度,搂膝拗步显著增加了膝关节在矢状面上的应力,因此练习该动作可能对患有股髌关节炎的患者产生不良影响。
Abstract:
Objective:To investigate the efficacy of Tai Chi gait pattern on the loading at the medial compartment of the knee during exercise in individuals with early stage of knee osteoarthritis(OA).Methods:A crossover randomized design was conducted to compare kinematics and kinetics parameters of twenty-one individuals with early-stage knee OA from June 2020 to December 2020 in three different conditions:natural walking,Tai Chi Louxiaobu,and Daojuangong.The kinetics and kinematics data were included:peak knee flexion at early stance phase,peak knee adduction angle during stance,foot progression angle during stance,peak knee flexion moment,peak knee adduction moment,ankle valgus moment during stance and medial ground reaction force(GRF).Results:The peak knee flexion degree at early stance phase and foot progression during stance during Louxiaobu and Daojuangong were significantly increased compared with that under the natural walking condition(P<0.05).Moreover,the peak knee flexion angle and foot progression during Louxiaobu were significantly higher than that during Daojuangong(P<0.05).Significant smaller knee adduction angle during Louxiaobu was showed as compared with that during natural walking and Daojuangong.However,higher knee adduction angle was showed during Daojuangong when compared with that during natural walking(P<0.05).Significant higher knee flexion moment was showed during Louxiaobu as compared with that during the normal walking and Daojuangong(P<0.05).However,no significant difference was found between the normal walking and Daojuangong(P>0.05).Significant smaller knee adduction moment was showed during both Louxiaobu and Daojuangong as compared with that during natural walking(P<0.05).However,no significant difference was found in knee adduction moment between two Tai Chi gait patterns(P>0.05).No significant difference was found in ankle valgus moment between three conditions(P>0.05).Significant smaller medial GRF was showed in Daojuangong when compared with that during other two conditions(P<0.05).However,no significant difference was found in medial GRF between natural walking and Louxiaobu(P>0.05).Conclusion:Both Louxiaobu and Daojuangong can significantly reduce the loading at the medial compartment of the knee.However,due to the excessively high knee flexion angle,the Louxiaobu significantly increases the loading in the sagittal plane of the knee joint.Therefore,practicing this exercise may have adverse effects on patients with femoral-patellar arthritis.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金(81503592,81973875,82074466)上海市科委课题(21Y11921600)
△通信作者 E-mail:shgsyjs@139.com
更新日期/Last Update: 1900-01-01