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789
人到中年,身体开始出现各种退化性疾病,其中患上退化性膝关节炎可令人举步维艰,对生活带来很多不便。
物理治疗师指不少膝痛病人误解平时越动越会痛而减少活动,或怕麻烦而不做水疗运动,令膝痛恶化,推介膝关节炎病人进行加入臀部肌肉锻炼的护膝运动,有助改善病情。
治疗师指,临床上退化性膝关节炎十分普遍,病人主要50岁或以上,女性较男性多。整体退化性膝关节炎病人中64%有过重问题,另外56%病人日常从事提举重物工作,两者都因关节过度受压加剧退化,患病风险比一般人高5倍。
退化性膝关节炎一般指大腿骨与小腿骨之间关节退化,带来膝痛问题,膝部软骨磨蚀造成骨质增生是当中原因。其他因素包括肌腱失平衡,如大腿前方肌肉即股四头肌太弱,及大腿后方肌肉即腘绳肌太紧,或因臀部肌肉太弱,尤其臀部外展肌肉即臀中肌等。
常见症状包括膝痛、膝后肿胀、有发热感,病人会觉得膝部无力,尤其久坐后站立或起床时感膝部僵硬及日常难踎低或屈膝。
部份膝关节炎病人误解复康运动会加剧痛楚,宁减少活动,“病人做运动时有少少痛好正常,例如10分有6分痛”,适当的伸展及强化肌肉锻炼有助改善病情,若运动时感到很痛,可减少动作次数及时间或隔日做。
膝关节炎病人进行水疗也有好处,不少人误解“水疗要识游水”,惟水疗运动非指游水,而是肌肉锻炼如原地跑、弓箭步等,在水中进行有助减轻关节压力,一般池水略高于腰部便足够。
丹麦哥本哈根大学曾研究一批有严重退化性膝关节炎复发病人,参与连续12周、每周3次退化性关节炎抢救运动,包括核心稳定训练、臀中肌力量训练、盆骨及髋关节稳定训练,完成后逾六成人疼痛明显改善。
近年有研究指臀部肌肉强度与退化性膝关节炎息息相关,臀肌强度不足影响病人功能性表现,同时令两边盆骨失平衡,大腿向内旋转,影响下肢运动力学,令膝关节和膝盖骨产生压力。新一代护膝复康运动着重整体下肢肌力训练,包括大腿前方及后方肌肉及臀部肌肉。
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