| Background: With the improvement of economic level,the aging of the population and the influence of obesity,the incidence of knee osteoarthritis is increasing year by year and showing a younger trend.Strengthening the strength of the quadriceps muscles is the common goal of most rehabilitation treatment programs,and it is also a training method recognized at home and abroad for knee osteoarthritis,and simple quadriceps training may increase knee pain and reduce patient compliance.In recent years,domestic and foreign studies have turned their attention to the large joint hip joint adjacent to the knee joint,and found that there is a direct relationship between the strength of the hip abductor muscle strength and the knee function.As a commonly used adjuvant treatment method in clinical rehabilitation,neuromuscular electrical stimulation combined with hip abductor electromyography stimulation intensive training on the basis of conventional rehabilitation training provides a new treatment plan for clinical rehabilitation and gradually becomes the target of research.Objectives:In this study,the effects of hip abductor electromyography stimulation on body function,balance,muscle strength,gait and plantar pressure in patients with knee osteoarthritis were explored through a 6-week intensive training session.Methods: In this study,60 patients with knee osteoarthritis were treated in the outpatient clinic,knee-preserving clinic and arthropathy outpatient clinic of Tianjin Hospital from January 2022 to October 2022.The experiment was divided into three groups: control group(n=20): conventional rehabilitation training group for lower limb muscles,experimental group 1(n=20): hip abductor muscle strengthening training group,experimental group 2(n=20)hip abductor electromyography stimulation strengthening training group.The total duration of each training session is about 60 minutes,3 times a week for 6 weeks.Three groups of patients were collected at baseline and 6 weeks later,respectively,30 s chair-stand test(30s-CST),The Western Ontario and Mc Master Universities Arthritis Index(WOMAC),and Berg Balance Scale(BBS),relative peak moment of hip abductor muscle,initial knee landing angle,peak knee flexion angle,knee range of motion,stride length,stride speed,anterior,middle and posterior foot impulse percentage,and peak pressure on the inside and outside of the heel were analyzed.Results:1.The number of 30s-CST in the three groups was increased compared with that before the intervention,and the difference was statistically significant(p<0.05).There were statistically significant differences between the three groups of patients with30s-CST after intervention(p<0.05).2.The WOMAC scale pain,stiffness,joint function and total scores of the three groups were significantly lower than those before the intervention(p<0.05).There were significant differences in pain,joint function and total score between the three groups(p<0.05),and there was no significant difference in the improvement of stiffness between experimental group 2 compared with experimental group 1 after 6weeks of intervention(p>0.05).3.The scores of the Berg balance scale were improved compared with those before the intervention in all three groups,and the difference was statistically significant(p<0.05).There were significant differences between the three groups after the intervention on the Berg Balance Scale(p<0.05).4.The relative peak moment of hip abductor muscle in the three groups was higher than that before the intervention,and the difference was statistically significant(p<0.05).There were significant differences between the three groups for the relative peak moment of the hip abductor muscle after intervention(p<0.05).5.The initial landing angle of the knee joint in the three groups was significantly lower than that before the intervention(p<0.05),and the peak knee flexion angle and the range of motion of the knee joint were increased compared with the degree of motion before the intervention,and the differences were statistically significant(p<0.05).After the intervention,it was found that the difference between the three groups of patients was statistically significant(p<0.05),the peak knee flexion angle and knee range of motion were statistically significant between experimental group 1and the control group and experimental group 2(p<0.05),and the difference between experimental group 2 and experimental group 1 was not statistically significant(p>0.05).The stride length and stride speed of the three groups were significantly higher than before the intervention(p<0.05).There were significant differences in stride length and stride speed between the three groups after intervention(p<0.05).6.The percentage of post-foot impulse,the percentage of intermediate foot impulse and the percentage of pre-intervention were statistically significant in the three groups(p<0.05).The percentage of hind foot impulse and the percentage of anterior foot impulse were statistically significant between the three groups(p<0.05),the difference between the three groups of patients was statistically significant(p<0.05)compared with the experimental group 1 and the control group,and the difference between experimental group 2 and experimental group 1 was not statistically significant(p>0.05).The difference between the three groups was statistically significant compared with the medial heel pressure peak and the lateral heel pressure peak compared with the pre-intervention(p<0.05).Compared with the inner and outer heel pressure peaks,the difference between the control group and the experimental group 1,and the control group and the experimental group 2 was statistically significant(p<0.05),and the difference between the experimental group 1and the experimental group 2 was not statistically significant(p>0.05).Conclusion:1.Hip abductor electromyography stimulation intensive training can improve the sensitivity and physical function level of the lower limbs of KOA patients,and enhance the patient’s balance ability by reducing the pain level of the patient’s knee joint.The effect on the relative peak moment of hip abductor muscles was obvious,indicating that the effect of enhancing muscle strength could be achieved through 6 weeks of training,and the effect of strengthening muscle strength training could be achieved by increasing neuromuscular electrical stimulation while actively moving the hip abductor muscle.2.Hip abductor electromyography stimulation strengthening training improves the initial landing angle of the knee joint obviously,and hip abductor muscle strengthening training combined with conventional training can improve the joint range of motion of the knee joint to a certain extent,on this basis,there is no obvious difference in combined electrical stimulation.3.Hip abductor electromyography stimulation intensive training has the effect of improving stride length and gait speed,the percentage of forefoot impulse and the percentage of hind foot impulse are improved,and the inner and outer pressure of the heel gradually develops in a better direction by shifting the center of gravity of the body after training.4.Compared with traditional quadriceps training,this experiment reduces the pain induced during training,improves training compliance,and provides a new option for KOEA clinical rehabilitation. |
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