| Objective:1 To investigate the cognitive status of knee osteoarthritis in middle-young people.2 Four soft tissue measurement points in the lower thigh and three soft tissue measurement points in the middle and upper shank are measured.To study whether the soft tissue tension at the measurement point affects attack of knee osteoarthritis and explore the factors affecting the soft tissue tension.Methods:1 A questionnaire survey was conducted among young and middle-aged patients and a small number of elderly patients in the outpatient department of orthopedics of Wang Jing hospital of Chinese Academy of Traditional Chinese Medicine and Institute of Osteopathic Research.The cognitive data of knee osteoarthritis(KOA)were collected,and Fisher’s exact test and Chi-Square test were used for statistical analysis.2 A soft tissue tension test analysis system was used to evaluate soft tissue tension of the outpatients with knee osteoarthritis and healthy volunteers from Wang Jing hospital of Chinese Academy of Traditional Chinese Medicine.The soft tissue tension was measured at the points of the vastus medialis,rectus femoris,vastus lateralis,semitendinosus,popliteal Transverse lines,gastrocnemius muscle and tibialis anterior muscle.And the statistical analysis of inter-group pairing and logistic regression model analysis were used to analyze the date.Statistical Results:1 About 75%of the respondents scored below 21 points(poor and average cognition),and only 25%scored between 21 and 31 points(excellent cognition).The respondents have poor awareness of the importance of health education(34.7%).According to Fisher’s exact test and chi-square test,the cognitive difference of KOA among people with different characteristics was only reflected in individual aspects.There was no significant difference in the overall cognition of KOA among different characteristics people.2 Correlative study Results of periknee soft tissue tension and KOA:① If take no account of the difference in baseline between the two groups,and there was no difference in the measured distance between the medial femoral muscle point and the semitendinosus muscle point by statistics.The soft tissue tension of the medial femoral muscle point in the middle-aged and elderly patients who have KOA and abnormal BMI was larger than that of the healthy volunteers,and the soft tissue tension at the semitendinosus was smaller than in the healthy volunteers.Soft tissue stiffness of vastus medialis point and semitendinosus point was lower than that of healthy volunteers.② Among the middle-aged and elderly,The soft tissue tension at the medial femoral muscle point was greater in KOA patients than people without KOA.③ There was no significant difference in soft tissue tension of the quadriceps femoris measurement point between middle-aged and elderly women,regardless of whether they had KOA.④ Gender has an effect on soft tissue tension,which needs further study.⑤ In the middle and elderly people who overweight and obesity,there was no significant difference in the soft tissue tension of the quadriceps femoris at each measurement point between the middle and elderly patients with KOA and the middle and elderly people without KOA.The soft tissue stiffness of medial femoral muscle point in KOA patients was worse than that without KOA.⑥ In the middle and elderly people who have normal BMI,the soft tissue tension of rectus femoris point and lateralis femoris point in KOA patients was worsethan that without KOA.⑦ BMI has effect on soft tissue tension.When leanness,overweight and obesity,the soft tissue tension measured on the body surface may not reflect the true tension.⑧ In the health volunteer group,the soft tissue tension of the femoral rectus muscle point was larger than that of young adults,and the soft tissue stiffness of the gastrocnemius point was worse than that of young adults.⑨ Age has an effect on soft tissue tension.The older the age,the greater the soft tissue tension may be,and the worse the soft tissue stiffness may be.⑩ Univariate logistic regression analysis showed that female,overweight,obesity and old age were risk factors for KOA.The risk of KOA was 3.596 times higher for women than for men,and 21.6 times higher for obese people than for normal BMI people,The risk of KOA in overweight people was 5.486 times higher than that in normal BMI people.The soft tissue tension of the medial femoral point,rectus femoris point,lateral femoral point and gastrocnemius point is the protective factor of KOA disease.The soft tissue stiffness of the medial femoral point,the lateral femoral point,the semitendinosus point,the popliteal transverse striatum,the anterior tibial point and the soft tissue tension of the semitendinosus point are risk factors for KOA disease.The risk of soft tissue tension at the semitendinosus point is second only to that of women.11 The OR value of age calculated from the regression model of this study was 1.269,OR 95%CI(1.121,1.436),which was a risk factor of KOA.The risk of KOA disease increased by 26.9%for every one year of age.The OR value of L200g of the medial femoral muscle point was 0.158,OR 95%CI(0.031,0.806).The risk of KOA disease was reduced by 84.2%for every one millimeter increase in L200g of the medial femoral muscle point.Among the factors involved in this study,age and soft tissue tension at the medial femoral muscle point have more important,direct and essential effects on the occurrence of knee osteoarthritis than other factors.12 The above study results were based on the data measured in this study.Due to the small sample size and the soft tissue tension that measured on the body surface are affected by bone structure,the baseline differences between the groups were unable to eliminate completely,so the extrapolation of the results should be cautious.Conclusion:1 The young and middle-aged people in Beijing who have higher education and have mental work and low,medium-income and medical insurance are not fully aware of KOA,and their overall knowledge of KOA is poor.The ZhiWeiBing scheme of knee osteoarthritis should start from improving the awareness of the importance of health education among young and middle-aged people,and strive to make doctors and patients take health education of knee osteoarthritis consciously as the content of their knowledge and should consciously apply it to concrete practice.Playing interesting and easy-to-understand KOA popular science videos in the prime time of public media plays a significant role in improving people’s awareness of knee osteoarthritis.2 The soft tissue tension of the medial femoral muscle point,the rectus femoris muscle point,the lateral femoral muscle point,the gastrocnemius muscle point was the protective factor of KOA.Soft tissue tension at semitendinosus point,female,overweight and obesity,advanced age are risk factors for KOA.3 BMI,age,gender and KOA all have an affect on the soft tissue tension at the measuring points around the knee.4 The soft tissue tension measured on the body surface that in the middle and late stage of KOA patients is affected by the bone structure.It should be analyzed in combination with the actual clinical situation of the soft tissue at the measuring site,and attention should be paid to the influence of age,sex,BMI,diseases and other factors on the soft tissue tension at the measuring site.5 The early prevention of KOA should lay equal stress on Jin and bones,but mainly on Jin.And priority should be given to the exercise of quadriceps femoris.If make periknee soft tissue tension especially the soft tissue tension of the medial femoral muscle spot slowly and continuously increases to a reasonable range,which can prevent the incidence of KOA and improve the long-term prognosis of KOA.Quadriceps isometric contraction exercise can increase quadriceps tension conveniently and effectively,and it could avoid isotonic contraction excise result to aggravate the discomfort of knee joint,which is more suitable for symptomatic KOA patients.The results of this study should be publicize to young and middle-aged people with poor KOA cognition,so that improve KOA prevention effectiveness. |
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