[1]张琥,张旻,龚幼波,等.太极拳对早期膝骨关节炎患者步态影响的研究[J].中医正骨,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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太极拳对早期膝骨关节炎患者步态影响的研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第30卷
期数:
2018年09期
页码:
34-38
栏目:
骨关节炎
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:
张琥; 张旻; 龚幼波; 谈绎文; 高宁阳; 顾新丰; 郑昱新; 詹红生
上海中医药大学附属曙光医院,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
关键词:
骨关节炎; 膝;  步态;  太极拳;  生物力学;  临床试验
Keywords:
osteoarthritis; knee;  gait;  shadow boxing;  biomechanics;  clinical trial
摘要:
观察太极拳对早期膝骨关节炎(knee osteoarthritis,KOA)患者步态的影响,并探讨其作用机理。方法:将68例早期KOA患者随机分为2组,每组34例,分别进行太极拳锻炼(太极拳锻炼组)和仰卧位下肢模拟骑自行车锻炼(自行车锻炼组),共锻炼12周。治疗前后采用三维步态捕捉分析系统采集患者的步长、步速及髋、膝关节内收力矩峰值。结果:至研究结束时,太极拳锻炼组1例脱落、自行车锻炼组2例脱落,均未说明原因不再来院治疗。治疗前2组患者的步长、步速比较,组间差异均无统计学意义(t=0.706,P=0.482; t=-0.584,P=0.561); 治疗结束后2组患者的步长、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],太极拳锻炼组的步长、步速均大于自行车锻炼组(t=7.399,P=0.000; t=3.774,P=0.000)。治疗前2组患者的髋关节内收力矩峰值比较,差异无统计学意义(t=-0.169,P=0.867); 治疗结束后太极拳锻炼组的髋关节内收力矩峰值增大[(0.60±0.10)Nm,(0.66±0.08)Nm,t=-6.124,P=0.000],自行车锻炼组的髋关节内收力矩峰值与治疗前比较差异无统计学意义[(0.60±0.10)Nm,(0.61±0.10)Nm,t=-1.359,P=0.184]; 治疗结束后太极拳锻炼组的髋关节内收力矩峰值大于自行车锻炼组(t=2.429,P=0.018)。治疗前2组患者的膝关节内收力矩峰值比较,差异无统计学意义(t=0.422,P=0.674); 治疗结束后太极拳锻炼组的膝关节内收力矩峰值减小[(0.28±0.09)Nm,(0.27±0.08)Nm,t=2.547,P=0.016],自行车锻炼组的膝关节内收力矩峰值与治疗前比较差异无统计学意义[(0.27±0.09)Nm,(0.27±0.08)Nm,t=-0.258,P=0.798]; 治疗结束后2组患者膝关节内收力矩峰值比较,差异无统计学意义(t=-0.261,P=0.795)。结论:太极拳锻炼和仰卧位下肢模拟骑自行车锻炼均能增加早期KOA患者的步长和步速,但太极拳锻炼的效果更好,其作用机制可能是通过锻炼增大髋关节内收力矩或限制其减小,降低膝关节内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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备注/Memo

备注/Memo:
基金项目:上海市中医药领军人才建设学术共同体成员培养项目(ZY3-RCPY-1-1001); “中医骨伤科学”国家重点学科建设项目(100508); 上海市名老中医药专家学术经验研究工作室建设项目(SHGZS-2017025); 上海市重中之重临床医学和重点学科建设项目(2017ZZ02024) 通讯作者:詹红生 E-mail:zhanhongsheng2010@163.com
更新日期/Last Update: 2018-09-20