An Experimental Study On The Effect Of Gluteus Activation/Stretching Exercise On The Function And Performance Of Patients With Knee Pain

Objective: Intervene patients with knee pain through gluteus activation/stretching exercise methods,explore the effects of different rehabilitation exercises on the pain,joint function and sports performance of patients with knee pain.Analyze the mechanism of the effect of gluteus activation/stretching exercise on improving the symptoms and sports performance of patients with knee pain.Provide reference and theoretical basis for sports rehabilitation of patients with knee pain.Methods: There were 35 volunteers meeting the research.they were selected and randomly divided into Control Group(CG),Gluteus Activation Group(GAG)and Gluteus Stretching Group(GSG).In the end,there were 27 volunteers completed the study,9 in each group.The CG did not give any intervention;GAG used gluteus exercise program,3 times a week,40 min every time,lasting 6 weeks;GSG used gluteus stretching exercise program,3 times a week,20 minutes each time,lasting 6weeks.Before and after the intervention,the ues of visual pain score,Lysholm knee joint score scale and joint mobility to evaluate the knee joint function of the subjects;The use of electromyography(EMG)test,isokinetic muscle strength test,climbing stairs and jump test to assess exercise capacity.Mathematical statistics were performed by SPSS17.0 statistical software.All data were expressed as mean ±standard deviation.Differences between groups were evaluated by one-way analysis of variance.Comparison within groups by paired-sample t-test.Take P<0.05 as the significance level of the difference.Result:(1)Before the intervention,the comparison of three groups baseline of subjects showed that the differences between the groups were not statistically significant(P>0.05).(2)Questionnaire evaluation:(1)After 6 weeks of intervention,the VAS scores of the GAG and GSG groups were significantly lower than those before the intervention(P<0.05).Among them,the GAG group decreased significantly(P<0.01);after 6weeks,the GAG group was significantly lower than the GSG and CG groups(P<0.05).(2)After 6 weeks of intervention,the LKSS scores of the GAG group and GSG group were significantly higher than those before the intervention(P<0.05).Among them,GAG group was very significantly increased(P<0.01);after 6 weeks,the GAG group was significantly higher than GSG group(P<0.05).(3)After 6 weeks of intervention,the range of motion of hip flexion,extension,adduction,abduction,and knee flexion in the GAG group were significantly higher than that before the intervention(P<0.05);After 6 weeks of intervention,The flexion and abduction range of hip joints in the GSG group were significantly higher than those before(P<0.05).(4)After 6 weeks,the squat angle in the GAG group was significantly higher than that before the intervention and 3 weeks after the intervention(P<0.01),which was significantly higher than that of the GSG and CG groups(P<0.01).After 6 weeks of intervention,the GSG group was significantly decreased than 6 weeks ago(P<0.05).(3)Surface EMG test:(1)After 6 weeks of intervention,the average EMG value of the gluteus maximus before the intervention,the integrated EMG value of the gluteus maximus and semitendinosus,and the contribution rate of the gluteus maximus increased significantly in the GAG group(P<0.05).The activation time of gluteus maximus and biceps femoris was shortened(P<0.05).(2)After 6 weeks of intervention,there was no significant change in the EMG indicators of the lower limbs in GSG and CG groups before and after the intervention(P>0.05).(4)Isokinetic test:(1)After 6 weeks of intervention,the peak torque and relative peak torque of the gluteal muscles in the GAG group were significantly higher than those before the intervention(P<0.05),and also significantly higher than those in GSG and CG groups(P<0.05);After 6 weeks of intervention,the peak torque values of the hamstrings and quadriceps muscles were also significantly higher than before the intervention(P<0.05);After 6 weeks,the peak torque ratio of hip joint flexors/extensors was significantly lower than before intervention(P<0.05),and was significantly lower than that of GSG and CG groups(P<0.05).(2)The peak torque,relative peak torque,flexor and extensor peak torque ratios of gluteal muscles,hamstrings and quadriceps in the GSG group were not significantly different before and after intervention(P>0.05).(5)Climbing stairs:(1)After 6 weeks of intervention,the floors corresponding to pain in climbing stairs and the floors corresponding to movement stopped in the GAG group were significantly higher than those before the intervention(P<0.05),and significantly higher than GSG and CG groups(P<0.05).(2)The GSG and CG groups were no significant difference(P>0.05).(6)Vertical jump:(1)After 6 weeks of intervention,the maximum force and explosive force of the lower limbs in the GAG group were significantly higher than before the intervention(P<0.05),and were also significantly higher than GSG and CG groups(P<0.05).(2)After 6 weeks of intervention,the maximum force value and explosive force of the GSG group were significantly lower than before the intervention(P<0.05),and significantly lower than CG group(P<0.05).Conclusion:(1)6 weeks of gluteus activation training can significantly reduce knee joint pain,improve knee and hip joint mobility,and increase knee joint motor function scores.(2)6 weeks of gluteus activation training can adjust and optimize the force sequence and contribution rate of the lower limb muscles,improve the endurance and explosive power of the lower limbs,and enhance the performance of the lower limbs when climbing stairs.(3)6 weeks of gluteus stretching training can significantly alleviate knee joint pain,improve hip joint flexion and abduction range,and increase knee joint motor function score,but its effect on alleviating knee joint pain and improving motor function score is not as good as gluteus activation Training effect.(4)6 weeks of gluteus stretching training has no significant effect on the force sequence and contribution rate of the lower limb muscles;it has a promoting effect on the absolute strength and endurance of the gluteal muscles and hamstrings.However,it will reduce the explosive performance of the lower limbs.