| Research background:Knee Osteoarthritis(KOA)has increasingly become a Knee degenerative disease that seriously affects the physical function and life quality of middle-aged and elderly people.Age is positively correlated with KOA,and the incidence of KOA will increase with aging.In addition to the insufficient strength of the quadriceps femoris,the muscle strength around the knee joint of KOA patients also decreased to varying degrees,which indicates that it is necessary for KOA patients to carry out comprehensive and systematic training of the muscle strength of the lower limbs.In recent years,blood flow restricted exercise has been gradually applied to the rehabilitation of musculoskeletal system diseases,which can effectively enhance muscle strength in a short period of time,and has gradually become a potential effective treatment method of muscle strength training.Objective: In this study,blood flow restriction(BFR)combined with low resistance exercise(LRE)was intended to effectively promote the rehabilitation of knee joint function in patients with KOA.And provide more safe and effective muscle strength training methods for the rehabilitation of patients with KOA,thus easing the process of KOA.Methods: In this study,60 patients with knee osteoarthritis who were admitted to rehabilitation Clinic and knee joint Clinic of Rehabilitation Medicine Department of Tianjin Hospital from February 2021 to September 2021 were randomly assigned to the experimental group(blood flow restricted exercise combined with low intensity resistance exercise)and the control group(routine muscle strength training of lower limbs).In addition to the quadriceps femoris blood flow restriction exercise combined with 30% one Repetition maximum(1RM)resistance exercise,muscle strength training of other lower limb muscles in the experimental group was consistent with the control group.Cross-sectional area(CSA),Sufface electromyography(s EMG)signal acquisition,thigh circumference,4*10 m fast walking test(4*10 m)were evaluated before and 6 weeks after the experiment-Fast Pace Walk Test,30 s Chair-stand Test(30S-CST),The Western Ontario and Mc Master Universities Arthritis Index(WOMAC),Japanese Orthopaedic Association Scores(JOA),The changes of knee mri results and adverse events during the experiment were recorded.Statistical methods:SPSS23.0 was used for statistical analysis.The counting data were analyzed and processed by Fisher's exact probability test or Chi-square test,and described as "frequency and percentage".If the measurement data were normally distributed and had uniform variances,the independent sample T test and paired sample T test were used for inter-group and intra-group comparison,respectively,described by "mean ±standard deviation".Otherwise,mann-Whitney U rank-sum test and Wilconxon ranksum test were used for inter-group and intra-group comparisons,respectively,and were described as "median and quartile".If P < 0.05,statistical differences were observed.Results:1.Muscle strength results:After 6 weeks of rehabilitation intervention,the CSA of the quadriceps femoris in both groups was significantly increased,and there was no statistical difference in the increase of the CSA of the quadriceps femoris between the two groups(P > 0.05),but the difference and change rate of the CSA of the experimental group were significantly higher than that of the control group(P < 0.05).After 6 weeks of intervention,thigh circumference in both groups was significantly increased compared with that before the experiment(P < 0.05),and thigh circumference in patients with 10 cm upper edge of patella was significantly increased in the experimental group than in the control group(P < 0.05).2.Surface EMG results:After 6 weeks of rehabilitation intervention,the RMS values of VM and VL and the ratio of VM/VL and BF/VL of patients in the standing up stage showed statistical differences compared with before the experiment(P < 0.05).There were statistically significant differences in THE RMS value and the ratio of VM/VL in control group compared with before the experiment(P < 0.05).The increase of VM/VL surface EMG ratio in the experimental group was higher than that in the control group(P < 0.05).The RMS values of VM and VL and the ratio of VM/VL and BF/VL of patients in the experimental group in the sitting stage were statistically different from those before the experiment(P < 0.05),which was consistent with the results in the standing up stage.The RMS values of VM,VL and BF and the ratio of BF/VL in control group were statistically different from those before the experiment(P < 0.05).The ratio of BF/VL surface EMG signal in the experimental group was lower than that in the control group during the sitting stage(P < 0.05).3.Results of knee function:Results of 4*10m brisk walking showed that after 6 weeks of intervention,the walking speed of patients in both groups was significantly improved compared with that before the experiment(P < 0.05),and the walking speed of patients in the experimental group was improved faster(P < 0.05).30s-CST results showed that after 6 weeks of rehabilitation intervention,the number of standing-sitting in the experimental group was significantly increased(P < 0.05),and the number of standing-sitting in the experimental group was significantly higher than that in the control group(P < 0.05).4.Scale evaluation Results:WOMAC scale results showed that after 6 weeks of rehabilitation intervention,the scores of patients in both groups were significantly lower than those before the experiment(P < 0.05),and the scores of patients in the experiment were significantly lower than those in the control group(P < 0.05).The score of JOA knee efficacy showed that after 6 weeks of intervention,the treatment effect was significantly improved in both groups compared with before the experiment(P < 0.05),and the score of knee efficacy in the experimental group was significantly higher than that in the control group(P < 0.05).Conclusions:A total of 6 weeks of blood flow restriction exercise for the quadriceps femoris combined with 30%1RM resistance exercise showed that:1.Increase the quadriceps femoris cross-sectional area and thigh circumference in KOA patients to a certain extent;2,to improve the coordination of thigh muscle movement,body function and relieve knee pain and stiffness;3.Improve the quality of life of KOA patients on the premise of ensuring the therapeutic effect;4.In general,blood flow restricted exercise combined with low-intensity resistance training has more advantages in the improvement of lower limb muscle strength and lower limb function of patients with KOA,with good compliance and safety,and provides a more effective method for appropriate and safe muscle strength training for patients with KOA. |
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