目的

运用步态分析探析为期半年的八段锦练习对膝关节炎的疗效。

方法

选取2021年1月1日至2021年12月31日广州中医药大学第三附属医院住院的膝关节炎患者39例，纳入标准：（1）符合美国风湿病学会关于膝关节炎的诊断标准；（2）受试者年龄在50岁以上，在加入研究前至少有半年膝关节炎症状；（3）患者未参与其他的运动。排除标准：（1）脊柱、髋、踝、足等部位关节疼痛或畸形者、行动不便者、曾有髋膝、踝关节手术史者；（2）在进入研究前1年内膝关节注射皮质类固醇或透明质酸的患者；（3）合并有膝关节肿瘤、结核、感染、类风湿等其他疾病者；（4）合并有严重心脑血管疾病或脏器衰竭不能耐受刺激者及精神病患者。患者按入院顺序编号采用随机数字表法分为3组，各组13例。对照组采用常规治疗；2次组在常规治疗基础上每周2次练习八段锦，30 min/次；5次组在常规治疗基础上每周5次练习八段锦，30 min/次。于练习前、练习后8周、6个月，收集步态分析仪测量的时空参数：步速、步频、步长及单足支撑相时间，采用重复测量方差分析和非参数检验等对资料进行统计分析。

结果

练习前对照组、2次及5次组在各步态时空参数组间比较差异均无统计学意义（均为P＞0.05）；练习八段锦6个月后，2次组左步长优于对照组（P＜0.05）；练习8周八段锦后，5次组右步长优于对照组（P＜0.05），练习半年八段锦后，5次组步频、左步长、左足单支撑优于对照组（均为P＜0.05）。对照组患者各步态参数在各检查时间点上组内比较差异均无统计学意义（均为P＞0.05）；2次组左步长在练习8周及6个月后优于练习前，差异具有统计学意义（F=5.83， P＜0.05），右步长在练习6个月后优于与练习前，差异具有统计学意义（F=5.73，P＜0.05）；5次组步频（F=12.28）、左足单支撑相（H=7.54）及右足单支撑相（H=8.51）在练习6个月后均优于练习前，差异具有统计学意义（均为P＜0.05）。

结论

练习八段锦后能改善受试者膝关节的运动功能。一周练习2次或者5次八段锦，均能改善受试者的运动步态，更提倡膝关节炎患者进行一周5次的练习。

Objective

To conduct a preliminary study on the efficacy of knee osteoarthritis after six months practice of Baduanjin by gait analysis.

Methods

Thirty-nine patients with knee osteoarthritis who were admitted to the Third Affiliated Hospital of Guangzhou University of Chinese Medicine from January first，2021 to December 31， 2021 were selected. Inclusion criteria： （1） meeting the American College of Rheumatology diagnostic criteria for knee osteoarthritis； （2） subjects were over 50 years of age and had symptoms of knee osteoarthritis for at least six months prior to study entry； （3） the patients was not involved in other sports.Exclusion criteria： （1） patients with joint pain or deformity in the spine， hip， ankle， foot and other parts of the joints， patients with mobility problems， patients with a history of hip， knee and ankle surgery； （2） patients with injections of corticosteroids or hyaluronic acid into the knee joints one year prior to entry into the study；（3） patients with a combination of knee tumours， tuberculosis， infections， rheumatoid diseases and other diseases；（4） patients with a combination of severe cardio-cerebral and cerebral vascular diseases or organ failure who cannot tolerate the stimulation and psychiatric patients. The patients were divided into three groups according to the order of admission using the random number table method， 13 cases in each group. Control group： conventional treatment； two times group： on the basis of conventional treatment， practice Baduanjin twice a week， 30 min/time；five times group： on the basis of conventional treatment， practice Baduanjin five times a week， 30 min/time.Spatio-temporal parameters measured by the gait analyser were collected pre-practice， eight weeks and six months after the exercises： step speed， step frequency， step length and foot single support phase were used to statistically analyse the data using repeated measures ANOVA and non-parametric tests.

Results

There was no statistically significant difference between groups in each gait temporal parameter in the control group，twice group and five times groupbefore practice （all P＞0.05）. After six months of practice of Baduanjin， the left step length of the two times group was better than the control group （P＜0.05）. After eight weeks of practice of Baduanjin， the right step length of the five times group was better than that of the control group （P＜0.05）， and after six months of practice of Baduanjin， step frequency， left step length， and left foot single support phase of the five times group were better than the control group （all P＜0.05）. There was no statistically significant difference in gait parameters among the control group at each examination time point（all P＞0.05）. The differences in the left step length eight weeks and six months after practice compared with the data before practice in the two times group was statistically significant （F=5.83， P＜0.05）. The difference in right step length at six months after practice compared to that before practice was statistically significant （F=5.73， P＜0.05）.The differences in step frequency（F=12.28）， left foot single support phase（H=7.54）and right foot single support phase（H=8.51）at six months after practice in the five times group was statistically significant when compared to the data before practice （all P＜0.05）.

Conclusions

The practice of Baduanjin can improve the subjects' knee movement function. Practising Baduanjin two times or five times a week can improve the gait， and it is more advocated that patients with knee osteoarthritis should practice it five times a week.