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目的 探讨膝骨关节炎(KOA)患者膝周肌力、步态时空参数的特点。方法 选取2023年11月～2024年12月北京大学国际医院筛选的45名受试者，包括按照膝关节诊疗指南纳入的15例膝骨关节炎患者，15例中老年健康人及15例年轻健康人，分别设为KOA组、对照组、青年组。使用等速肌力测试系统、步态分析系统分别测试3组人群的屈伸膝肌力及步态时空参数特征，并分析KOA患者屈伸膝肌力与步态时空参数的相关性。结果 KOA组股四头肌等长收缩，60°/s、180°/s等速收缩峰值力矩(peak torque, PT)和峰值力矩比值(hamstring/quadriceps ratio, H/Q),以及腘绳肌60°/s等速收缩PT值均显著小于青年组，差异有统计学意义(P<0.05)。KOA组股四头肌和腘绳肌60°/s等速收缩PT值显著小于对照组，差异有统计学意义(P<0.05)。3组受试者腘绳肌180°/s等速收缩PT值及60°/s等速收缩H/Q比较，差异无统计学意义(P> 0.05)。KOA组步速显著小于对照组和青年组，步幅显著小于青年组，差异有统计学意义(P<0.05),3组受试者足偏角(foot progression angle, FPA)和地面反作用力(ground reaction force, GRF)差异无统计学意义(P> 0.05)。KOA组步速与股四头肌等长收缩PT值，60°/s股四头肌，60°/s、180°/s腘绳肌等速收缩中度正相关(P<0.05)。KOA组步幅与股四头肌等长收缩PT值、60°/s、180°/s等速收缩PT值以及腘绳肌60°/s、180°/s等速收缩PT值中度正相关(P<0.05)。KOA组GRF与60°/s、180°/s腘绳肌等速收缩PT值中度正相关(P<0.05)。结论 膝周肌力减退是KOA患者步态异常的重要诱因，为临床针对性肌力训练、优化KOA康复方案提供了理论与实践依据。
Abstract：Objective To investigate the characteristics of muscle strength around the knee and gait spatio-temporal parameters in patients with knee osteoarthritis(KOA)and whether there is a relationship between them. Methods From November 2023 to December 2024,45 subjects were included from Peking University International Hospital, including 15 patients with knee osteoarthritis, 15 middle-aged and elderly healthy people and 15 young healthy people according to the knee joint diagnosis and treatment guidelines. The Biodex isokinetic muscle strength test system and the Gaitboter gait analysis system were used to test the knee flexion and extension muscle strength and gait space-time parameter characteristics of the three groups, and the correlation between these parameters with KOA was analyzed. Results The peak torque(PT)value and hamstring-to-quadriceps(H/Q)of isometric contraction of quadriceps femoris at 60°/s and 180°/s, and the PT value of isometric contraction of hamstring at 60°/s in KOA group were significantly lower than those in young group. The PT values of quadriceps femoris and hamstrings at 60°/s isokinetic contraction in KOA group were significantly lower than those in control group(P < 0.05). The walking speed of the KOA group was significantly lower than that of the control group and the young group(P < 0.05),and the stride was significant. Conclusion The results confirm that the decrease of muscle strength around the knee is an important cause of gait abnormality in KOA patients, which provides theoretical and practical basis for clinical targeted muscle strength training and optimization of KOA rehabilitation program.
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基本信息:
中图分类号:R684.3
引用信息:
[1]马淑敏,王刚,高谦,等.膝骨关节炎对中老年人群膝周肌力和步态影响的分析研究[J].中华保健医学杂志,2026,28(03):208-212.
基金信息:
国家重点研发计划（2023YFC2412004）
2025-09-25
2025
2025-11-29
2026-01-09
2026
1
2026-03-31
2026-03-31