Application Of The Thought Of Gubingzhijin In The Prevention And Treatment Of Knee Arthropathy

Objective: To enrich the theoretical basis of the thought of Gubingzhijin through the study of neuromuscular characteristics of medial knee displacement (MKD) and to provide a clinical basis for the thought through observing the curative effect of Roujinzhenggu manipulation in treating knee osteoarthritis (KOA).Methods:56 subjects who perform MKD in a single leg squat and 56 normal subjects who don't were selected from the male youth volunteers. A maximal voluntary isometric contraction (MVIC) was performed for gluteus maximus,gluteus medius, hip adductor, gastrocnemius and tibialis anterior by handheld digital dynamometer and the peak force was recorded normalized to each subject's weight. A wireless surface electromyography (sEMG) system was used to record the muscle activity ofthese muscles in single leg squat (SLS). Mean EMG amplitude during the descent phase of the SLS was normalized to MVIC activation.80 KOA cases were randomly divided into the experimental group and the control group. The control group was treated by regular manipulation method. The experimental group was treated by Roujinzhenggu manipulation combined with kinetotherapy. The course of treatment was 3 weeks. The effect was evaluated by visual analog scale (VAS) and Lequesne index score before the treatment and one week after the treatment.Results:No significant differences were observed between groups for any of the normalized values for the 5 muscle groups tested with MVIC trials. The normalized RMS amplitude of gluteus maximus and gluteus medius of MKD groupwere significantly lower than that of the normal group. The normalized RMS amplitude of hip adductor, medial gastrocnemius,lateral gastrocnemius, and tibialis anterior were significantly higher than that of the normal group.The VAS score and Lequesne index score had a very significant improvement in both the two KOA groups (P<0.01), but the experimental group had a better result (P<0.01). The comprehensive curative effect of the experimental group was better than that of the control group.Conclusion:The medial knee displacement may be associated with a more activation of hip adductor, gastrocnemius, and tibialis anterior and less activation of gluteus maximus and gluteus medius. Altered hip adductor and gluteal musculature coactivation and the coactivation of gastrocnemius and tibialis anterior may contribute to medial knee displacement during a SLS. The improvement of lower limb muscle function with the idea of Gubingzhijin should be emphasized in the prevention and treatment of knee injury.With Gubingzhijin as the guiding ideology, Roujinzhenggu manipulation combined with kinetotherapy is significantly effective for knee osteoarthritis by relieving pain and improving knee function.