膝骨关节炎患者本体感觉、肌力及关节功能的相关性研究

Correlations Between Joint Proprioception, Muscle Strength, and Functional Ability in Patients with Knee Osteoarthritis

中文关键词:  脑性瘫痪 脑瘫类型 手功能

英文关键词:Knee osteoarthritis Muscle strength Proprioception Joint function

中文摘要:

      目的 通过研究膝骨关节炎患者的膝关节本体感觉、屈伸肌群峰力矩及膝关节功能，探索三者之间的相关性。方法 本研究共纳入56例膝骨关节炎患者。本体感觉评估和膝关节屈伸肌群肌力评估均采用Isomed 2000等速肌力测试训练仪。个体本体感觉功能以膝关节的被动运动感知阈为评价指标，膝关节屈伸肌群肌力以膝关节屈伸肌群的峰力矩及峰力矩体质量比为评价指标。膝关节功能评估采用WOMAC问卷量表。同时对上述三者的相关性进行分析。再以膝骨关节炎患者关节功能WOMAC评分为因变量，年龄、体质量指数、 VAS疼痛评分、双侧Kellgren-Lawrance分级均值、双侧股四头肌肌力均值、双侧腘绳肌肌力均值、双侧本体感觉误差均值作为自变量进行多元逐步回归分析。结果 膝关节左、右侧本体感觉与股四头肌肌力及腘绳肌肌力均存在负相关（ P<0.05）。膝关节左、右侧本体感觉均值与WOMAC评分中的关节疼痛、关节僵硬无明显相关性，但与关节日常生活活动存在正相关（r=0.659， P<0.05）。WOMAC评分与左、右侧股四头肌肌力均值和腘绳肌肌力均值均存在负相关（r分别为－0.511、－0.408， P<0.05）。经多元逐步回归分析，本体感觉〔标准化偏回归系数（B）=0.385， P=0.007〕、VAS疼痛评分（B=0.347， P=0.014）与WOMAC评分呈正相关。结论 膝骨关节炎患者本体感觉-被动运动感知阈的低下与关节屈伸肌群肌力下降及关节功能下降有关。膝骨关节炎患者疼痛程度、本体感觉功能一定程度上参与影响膝骨关节炎患者的关节功能。

英文摘要:

      Objective To validate the function score for adult Tibetans with Kashin-Beck disease (FSAT-KBD) measuring daily life and work functional status of KBD patients. Methods From September to October 2010, 352 adult KBD patients in Rangtang County of Aba Tibetan autonomous region were invited to complete FSAT-KBD. The internal consistency of FSAT-KBD was assessed using Cronbach’s alpha coefficients. Principal component analysis with varimax rotation was performed to explore factor structure of the instrument, with item-domain correlations being examined using Spearman’s rank correlation tests. Discriminant validity of the FSAT-KBD was assessed by comparing scores of the respondents with different ages and different functional status. Convergent validity of the FSAT-KBD was assessed through a comparison with the medical outcomes study short form health survey (SF-12) and visual analogue scale (VAS). Results 338 KBD patients (a response rate of 96.0%) completed the questionnaire in an average of (3.2±1.6) min. The instrument achieved a Cronbach’s alpha of 0.945, with item-to-domain correlations exceeding 0.0. Two latent factors were extracted, which explained 72.8% of the total variance. The factor structure fitted well with our conceptual hypothesis. Respondents with different age, duration of suffering and number of affected joints had different FSAT-KBD scores. The FSAT-KBD results were correlated with those of SF-12 and VAS. Conclusion FSAT-KBD is a reliable and valid instrument for measuring daily functional status of adult KBD patients in Aba Tibetan autonomous area in China.