Objective To explore the effects of intra-articular injection of platelet-rich plasma (PRP) on improving pain, joint function, and muscle strength of knee osteoarthritis (KOA). Methods From March 2017 to August 2019, 100 cases of KOA diagnosed and treated in the First Affiliated Hospital of Harbin Medical University were selected. They were divided into intervention group and control group with 50 cases in each group by random number table method. The patients in the intervention group were given intra-articular injection of PRP (5 mL/time, 1 time/week, 6 times in total) combined with isokinetic strength training (2 times/d, 3 d/week, for 12 consecutive weeks) treatment, and the patients in the control group were given intra-articular injection of sodium hyaluronate (2 mL/time, 1 time/week, for 12 consecutive weeks) combined with isokinetic strength training (2 times/d, 3 d/week, for 12 consecutive weeks). The incidence of adverse reactions during the treatment process and the clinical efficacy at 12 weeks of treatment and 6 months after treatment were recorded, and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scoring system was used to evaluate the knee joint function. When the isokinetic strength training instrument measured an angle of 90°/s, the knee joint flexor and extensor peak torque (PT), total work (TW), and average power (AP) were recorded. Results Forty-nine patients of each group completed the study. The between-group differences in WOMAC pain, stiffness, and joint function scores, and extensor and flexor PT, TW, and AP before treatment were not statistically significant (P>0.05). At 12 weeks of treatment and 6 months after treatment, the WOMAC scores of pain, stiffness, and joint function in the two groups were lower than those before treatment (P<0.05), and the extensor and flexor PT, TW, and AP were higher than those before treatment (P<0.05). Six months after treatment, the WOMAC scores of pain, stiffness, and joint function in the intervention group were lower than those in the control group (P<0.05), and the extensor and flexor PT, TW, and AP in the intervention group were higher than those in the control group (P<0.05). There was no significant difference in the effective rate between the two groups at 12 weeks of treatment (95.9% vs. 89.8%, P>0.05). The effective rate in the intervention group was higher than that in the control group 6 months after treatment (93.9% vs. 79.6%, P<0.05). No serious adverse reaction occurred in the two groups during the treatment. Conclusion Intra-articular injection of PRP can reduce pain, improve muscle strength, and improve joint function in patients with KOA, and the long-term effect is better than that of conventional drugs.
ObjectiveTo observe the effectiveness of core endurance isokinetic strength training on subacromial impingement syndrome (SAIS) rehabilitation.MethodsSAIS patients were selected from the Rehabilitation Department, Second Affiliated Hospital of Inner Mongolia Medical University from January 2018 to June 2019. The patients were randomly divided into observed group and control group by random number table method. The patients in control group were treated by keritherapy, cold, standard physiotherapy (PT) and exercise. At the same time, the patients in observed group were treated by core endurance isokinetic strength training combined with keritherapy, cold and standard PT. Both two groups were treated for 8 weeks. The patients were scored with visual analogue scale (VAS), Shoulder Pain and Disability Index (SPADI), Short Form 36 Healthsurvey Questionnaire (SF-36), flexor peak torque (FPT) and extensor peak torque (EPT) in pre and post treatment.ResultsA total of 59 patients with SAIS were enrolled. No exfoliating cases. There were 31 cases in the observed group and 28 cases in the control group. Pre-treatment, there were no significant difference in FPT, EPF, VAS, SPADI and SF-36 between the two groups (P>0.05). Post-treatment, there were no significant difference in EPT and VAS between the two groups (P>0.05); FPT [(62.65±10.17) N·m], SPADI [(53.18±10.25) points] and SF-36 [(35.54±11.39) points] in the observed group were significantly improved compared with the control group [(56.28±9.55) N·m, (61.05±9.41) points, (42.65±10.74) points] (t=2.473, 3.061, 2.460; P=0.014, 0.003, 0.017); FPT in both groups, and EPT in the observed group were improved compared with that of the pre-treatment (P<0.05); the EPT of the control group was improved compared with that of the pre-treatment, but the difference was not statistically significant (P>0.05); VAS, SPADI and SF-36 in the two groups were improved compared with those of the pre-treatment (P<0.05).ConclusionsCore endurance isokinetic strength training could improve the core stability of subacromial impingement syndrome patients. Satisfactory musculoskeletal dynamic chain plays a vital role in subacromial impingement syndrome rehabilitation.
Objective To systematically review the rehabilitation effect of isokinetic muscle training on knee muscle strength, functional walking ability and dynamic balance in post-stroke patients. Methods PubMed, Ovid Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Chongqing VIP, and Wanfang databases were searched online for randomized controlled trials on isokinetic muscle training of lower limbs in post-stroke patients. The retrieval time was from inception to October, 2022. Endnote X9 software was used to manage the literature. Cochrane Manual 5.1.0 was used for quality assessment, and RevMan 5.4 software was used for meta-analysis. Results A total of 20 randomized controlled trials were included in the study, with the intervention group using isokinetic muscle training of the lower extremities or combined with conventional rehabilitation training and the control group using conventional rehabilitation training and/or other intervention, with a total of 1448 study subjects. Meta-analysis results showed that the differences in knee flexion peak torque [mean difference (MD)=5.85 N·m, 95% confidence interval (CI) (4.84, 6.85) N·m, P<0.00001], knee extension peak torque [MD=9.09 N·m, 95%CI (4.83, 13.36) N·m, P<0.0001], Time Up Go test [MD=–4.70 s, 95%CI (–6.68, –2.72) s, P<0.00001], 10-meter walking test [MD=–4.71 s, 95%CI (–9.12, –0.31) s, P=0.04], Fugl-Meyer Lower Extremity Motor Function Assessment score [MD=6.61, 95%CI (3.52, 9.70), P<0.0001], and Berg Balance Scale score [MD=5.61, 95%CI (0.91, 10.31), P=0.02] were statistically significant. Conclusion Isokinetic training may improve knee strength and functional walking ability in post-stroke patients, but there is still no strong evidence of improvement in motor function and balance.
Objective To investigate the early effectiveness of fixed-bearing unicompartmental knee arthroplasty (FBUKA) in patients with anterior cruciate ligament deficiency (ACLD), and to evaluate postoperative muscle strength and functional recovery through isokinetic muscle strength testing. Methods A retrospective analysis was performed on the clinical data of 181 patients with unilateral medial compartment knee osteoarthritis who underwent FBUKA treatment between January 2023 and June 2024 and met the selection criteria. According to the integrity of the anterior cruciate ligament, the patients were divided into the ACLD group (45 cases) and the anterior cruciate ligament intact (ACLI) group (136 cases). There was no significant difference in baseline data between the two groups (P>0.05), including age, gender, body mass index, affected side, disease duration, and preoperative Hospital for Special Surgery (HSS) score, Lysholm score, and visual analogue scale (VAS) score. A standardized rehabilitation protocol was adopted after surgery. Isokinetic muscle strength parameters [peak torque (PT) and total work (TW) of quadriceps and hamstring, and hamstring-to-quadriceps ratio (H/Q) at angular velocities of 60°/s and 180°/s] and HSS score, Lysholm score, and VAS score were measured preoperatively and at 6 weeks, 3 months, 6 months, and 12 months after operation; posterior tibial slope (PTS) was measured at 12 months after operation. Results All patients were followed up 12-18 months, with a mean of 13.6 months. No complication such as aseptic loosening of the prosthesis, dislocation of the mobile bearing insert, infection, or revision occurred after operation. Isokinetic muscle strength testing showed that at angular velocities of 60°/s and 180°/s, the PT and TW of quadriceps and hamstring significantly decreased and H/Q increased in both groups at 6 weeks after operation when compared with preoperative values (P<0.05); then PT and TW increased gradually, and H/Q decreased gradually. Except for no significant difference at 3 months after operation compared with preoperative values (P>0.05), all indicators were significantly different from preoperative values at 6 and 12 months after operation (P<0.05). There was no significant difference in isokinetic muscle strength parameters between the two groups at any time point before and after operation (P>0.05). The HSS score, Lysholm score, and VAS score at each postoperative time point in both groups significantly improved when compared with preoperative values (P<0.05), and there was no significant difference in each score between the two groups at each postoperative time point (P>0.05). At 12 months after operation, the PTS in the ACLD group was significantly smaller than that in the ACLI group (P<0.05). Conclusion For ACLD patients without anteroposterior knee instability, the isokinetic muscle strength recovery trajectory and clinical functional scores after FBUKA are comparable to those of ACLI patients. For such patients, FBUKA can achieve satisfactory muscle strength and functional recovery, and isokinetic muscle strength testing can provide objective quantitative evidence for postoperative rehabilitation evaluation.
