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中华关节外科杂志(电子版) ›› 2021, Vol. 15 ›› Issue (01) : 98 -103. doi: 10.3877/cma.j.issn.1674-134X.2021.01.016

所属专题: 文献

综述

运动治疗膝骨关节炎的实施方案及临床探索
李川1, 卜鹏飞2, 韩云峰3, 马伟3, 苏踊跃2, 蒙旭晗2, 张晓艳2, 徐永清2,()   
  1. 1. 650032 昆明,解放军联勤保障部队第九二〇医院骨科;650504 昆明医科大学
    2. 650032 昆明,解放军联勤保障部队第九二〇医院骨科
    3. 650032 昆明,抒坦运动康复与健康中心
  • 收稿日期:2020-10-11 出版日期:2021-02-01
  • 通信作者: 徐永清
  • 基金资助:
    云南省重大科技专项-生物医药重大专项(2018ZF008); 云南省卫健委临床中心建设重大项目(ZX20191001)

Implementation plan and clinical exploration of exercise therapy for knee osteoarthritis

Chuan Li1, Pengfei Bu2, Yunfeng Han3, Wei Ma3, Yongyue Su2, Xuhan Meng2, Xiaoyan Zhang2, Yongqing Xu2,()   

  1. 1. Department of Orthopaedic, 920th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Kunming 650032, China; Kunming Medical University, Kunming 650504, China
    2. Department of Orthopaedic, 920th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Kunming 650032, China
    3. Comfy Sports Rehabilitation and Health Center at Kunming, Kunming 650032, China
  • Received:2020-10-11 Published:2021-02-01
  • Corresponding author: Yongqing Xu
引用本文:

李川, 卜鹏飞, 韩云峰, 马伟, 苏踊跃, 蒙旭晗, 张晓艳, 徐永清. 运动治疗膝骨关节炎的实施方案及临床探索[J/OL]. 中华关节外科杂志(电子版), 2021, 15(01): 98-103.

Chuan Li, Pengfei Bu, Yunfeng Han, Wei Ma, Yongyue Su, Xuhan Meng, Xiaoyan Zhang, Yongqing Xu. Implementation plan and clinical exploration of exercise therapy for knee osteoarthritis[J/OL]. Chinese Journal of Joint Surgery(Electronic Edition), 2021, 15(01): 98-103.

骨关节炎是一种关节软骨退行性疾病,伴有软骨下骨损伤。膝关节骨关节炎是发生于膝关节的骨关节炎,它符合骨关节炎的共同特点,同时具有膝关节这特殊部位的特点,随着社会老龄化,膝关节骨关节炎患者数量不断增加,将成为第一个严重威胁老年人健康的慢性疾病。近年来,运动疗法已被证明对骨关节炎有益,国内外相关指南中都不同程度地推荐运动疗法。基于本研究团队临床运动治疗经验以及现有的文献证据以归纳总结并分享相关经验及具体治疗措施,以期提供适合国人的运动治疗膝关节骨关节炎的标准化方案。

Osteoarthritis is a degenerative disease of articular cartilage with subchondral bone damage. Knee Osteoarthritis is the osteoarthritis occurring in the knee joint, it is in line with the common characteristics of osteoarthritis, but also has the characteristics of this special part of the knee joint, with the aging of society, the number of patients with knee osteoarthritis is increasing, will become the first serious threat to the health of the elderly chronic disease. In recent years, exercise therapy has been proved to be beneficial to osteoarthritis, and it is recommended to varying degrees in relevant guidelines at home and abroad. Based on the clinical exercise therapy experience of the research team and the existing literature evidence, this paper summarized and shared relevant experience and specific treatment measures, in order to provide a clinical implementation plan for the exercise therapy of knee osteoarthritis for OA patients.

图1 膝关节关节炎的阶梯治疗
图2 下蹲过程。左、中、右图示站立、正确式下蹲和内扣式下蹲
图3 Y平衡测试
图5 放松外侧肌及髂胫束
图6 由易到难的臀中肌激活及平衡训练
图7 下肢卧蹬训练
图8 股四头肌内侧头练习。红色箭头示当伸膝关节到末端0°~30°时股四头肌力量得到最大激活,形变最高
图9 下蹲姿势的纠正过程。左、中、右分别示站立、错误下蹲及正确下蹲,要求躯干平面与小腿平面平行
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