膝骨关节炎的康复运动训练

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膝骨关节炎的康复训练

膝骨关节炎（kneeosteoarthritis,KOA)是指由多种因素引起的膝关节软骨纤维化、皲裂、溃疡、脱失而导致的以关节疼痛为主要症状的退行性疾病，好发50岁以上人群，女性明显高于男性。全球症状性骨关节炎发病率为10%～12%，65岁以上骨关节炎（OA）人群50%以上为膝骨关节炎（KOA）患者，其中女性发病率比男性高大约45%。KOA的病因与发病机制尚不明确，“慢性低度炎症（chroniclow-gradeinflammation)”致病的理论模型认为KOA是在年龄、性别、激素、体重、力学改变、微环境及结构异常等多危险因素共同作用下，关节内或全身出现“慢性低度炎症”，受累关节软骨、滑膜、软骨下骨、周围肌肉及韧带出现不同程度损伤、炎症与水肿，导致软骨细胞、细胞外基质和软骨下骨三者降解－合成偶联失衡，造成全关节不可逆性功能紊乱与结构畸形而发病。病理特点为关节软骨变性破坏、软骨下骨硬化或囊性变、关节边缘骨质增生、滑膜病变、关节囊挛缩、韧带松弛或挛缩、肌肉萎缩无力。

适当的康复训练可以加强关节周围肌肉力量，既可改善关节稳定性，又可促进局部血液循环，防止失用性萎缩。

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膝骨关节炎的康复运动视频

动作分解

一

股四头肌收缩

动作要领：仰卧，伸直膝关节进行股四头肌静力收缩。每次收缩尽量用力并坚持尽量长的时间，重复数次以肌肉感觉有酸胀为宜。

二

直腿抬高

动作要领：仰卧床上，伸直并抬高下肢与床面约呈30°角，坚持10秒，或训练至肌肉有酸胀感为止。

三

空中蹬自行车

动作要领：身体平躺，双腿朝上抬起，尽量向上提高。然后想象蹬自行车，左腿踩一圈，右腿踩一圈，双腿交替屈伸直至肌肉感觉有酸胀为宜

四

臀中肌练习

动作要领：健侧卧位，患侧下肢伸直抬高，与床面呈约45°角，训练坚持10秒，10次／组，3组／次；

五

臀大肌肌力练习

动作要领：俯卧，患侧下肢伸或屈膝行髋后伸练习，使大腿抬高，与床面呈约30°角。训练坚持10秒，10次／组，3组／次。

六

静蹲训练

动作要领：背靠墙，足与肩同宽，缓慢屈膝屈髋至半蹲位，髋膝关节屈曲角度不超过90°,角度过大会增加髌股关节的压力，反而使膝关节负荷过大，活动范围内不引起关节疼痛，坚持30~40秒，10次／组。

PS：

以上动作需要长期坚持，每天重复上述动作2-3次或每周不少于5天坚持训练。坚持6个月或以上膝关节疼痛程度和频率以及关节功能状态都会得到不同程度的改善。

西南风湿病专科

西南痛风诊疗中心

康复科

医院风湿免疫科、康复科

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