目的:探讨国家跆拳道队康复体系中的肌筋膜松解(myofascial release,MFR)手法对运动员膝关节功能的改善效果.方法:采用单被试实验多重基线设计,对6名运动员(WL、GQ、LS、SJ、ZY、ZQ)进行为期10个月的MFR手法干预.通过测量运动员主要踢击腿的Lysholm量表评分、运动员睡眠筛查问卷(Athlete Sleep Screening Questionnaire,ASSQ)得分、膝关节主动活动度(active range of motion,AROM)、膝关节被动活动度(passive range of motion,PROM)和压力疼痛感觉阈值(pressure pain threshold,PPT)等指标,反映运动员的膝关节功能、睡眠质量、膝关节活动度和压力疼痛感觉.采用超过基线期的中位数百分比(percentage of data points exceeding the median of baseline phase,PEM)进行个体疗效分析与相关性分析;选用Lysholm和PPT作为变量,使用线性混合模型对整体疗效进行分析.结果:1)在个体疗效方面,6名运动员Lysholm量表评分的PEM分别为0.82、0.82、0.64、0.73、0.55、0.82,其中,MFR手法对WL、GQ、ZQ等运动员膝关节功能的改善较为有效(0.7≤PEM<0.9),其余3名运动员则效果微弱(0.5≤PEM<0.7);6名运动员ASSQ得分的PEM分别为0.36、0.55、0.45、0.55、0.64、0.55,其中,MFR手法对WL与LS睡眠质量的改善效果差(PEM<0.5),其余4名运动员则效果微弱(0.5≤PEM<0.7);6名运动员AROM的PEM分别为0.76、0.88、0.92、0.88、0.70、0.92,其中,MFR手法对GQ、LS和ZQ膝关节AROM的改善有效(PEM≥0.9),SJ较为有效(0.7≤PEM<0.9),而WL和ZY则效果微弱(0.5≤PEM<0.7);6名运动员PROM的PEM分别为1.00、0.86、0.92、1.00、0.84、0.82,其中,MFR手法对WL、LS、SJ有效(PEM≥0.9),对GQ、ZY、ZQ较为有效(0.7≤PEM<0.9);6名运动员PPT的PEM均为1.00,MFR手法对PTT干预有效(PEM≥0.9).MFR手法对6名运动员膝关节改善效果由高到低依次为PPT、PROM、AROM、Lysholm评分和ASSQ得分.2)Lysholm评分与各变量存在显著相关性(P<0.05),AROM与PROM的相关性最为显著(P<0.01),ASSQ得分只与PPT相关性显著(P<0.05).3)在整体疗效方面,Lysholm评分在跟踪期高于干预期(β=-4.120,P<0.001)与基线期(β=-4.924,P<0.001),PPT在跟踪期低于干预期(β=4.485,P<0.001),高于基线期(β=-2.472,P<0.001).结论:MFR手法可以有效改善跆拳道运动员的膝关节活动范围与相关软组织状态,在一定程度上能够预防膝关节运动损伤的发生.
Empirical Study on the Effect of Myofascial Release Technique on Improving Knee Joint Function of National Taekwondo Team Athletes
Objective:Exploring the improvement of knee joint function in athletes through myo-fascial release (MFR) technique in the rehabilitation system of the national taekwondo team. Methods:The experiment used a single subject experiment with multiple baseline levels,and a 10 month MFR intervention was conducted on six athletes (WL,GQ,LS,SJ,ZY,ZQ) with time as the baseline. Based on knee joint motion sensation,subjective sleep quality,knee joint range of motion,and soft tissue status,five dependent variables were set:Lysholm knee score,Athlete Sleep Screening Questionnaire (ASSQ) score,active range of motion (AROM) of knee joint,passive range of motion (PROM) of knee joint,and pressure pain threshold (PPT). The percentage of data points exceeding the median of baseline phase (PEM) was used for individual efficacy analysis and correlation analysis. Finally,Lysholm knee score and PPT were selected as vari-ables to analyze the overall efficacy using a linear mixed model. Results:1) In terms of individual efficacy,the PEM values of Lysholm knee scale of 6 athletes were 0.82,0.82,0.64,0.73,0.55,0.82,respectively,MFR technique was more effective in improving knee joint function in WL,GQ,and ZQ athletes (0.7≤PEM<0.9),but had a weak effect on the other three athletes (0.5≤PEM<0.7);the PEM values of ASSQ scores of the six athletes were 0.36,0.55,0.45,0.55,0.64,0.55,respectively,the improvement effect of MFR technique on sleep quality of WL and LS athletes was poor (PEM<0.5),while the intervention on the other four athletes showed weak efficacy (0.5≤PEM<0.7);the PEM values of AROM of six athletes were 0.76,0.88,0.92,0.88,0.70,0.92,respectively,the MFR technique was effective in improving AROM of the knee joints in GQ,LS,and ZQ athletes (PEM≥0.9),more effective in SJ (0.7≤PEM<0.9),and had a weak effect on WL and ZY (0.5≤PEM<0.7);the PEM values of PROM of six ath-letes were 1.00,0.86,0.92,1.00,0.84,0.82,respectively,the MFR technique was effective for WL,LS,and SJ (PEM≥0.9) in terms of PROM of the knee joint,and was more effective for GQ,ZY,and ZQ (0.7≤PEM<0.9);the PEM values of PPT of six athletes were 1.00,the inter-vention of MFR technique on the mechanical pressure pain threshold was effective (PEM≥0.9). Therefore,the improvement effect of MFR technique on the knee joints of six athletes was ranked from high to low as PPT,PROM,AROM,Lysholm knee score,and ASSQ score. 2) Lysholm knee score was significantly correlated with all variables (P<0.05),AROM was most signifi-cantly correlated with PROM (P<0.01),and ASSQ score was only significantly correlated with PPT (P<0.05). 3) In terms of overall efficacy,the Lysholm knee score follow-up period was higher than the intervention expectation (β=-4.120,P<0.001) and baseline period (β=-4.924,P<0.001),while the PPT follow-up period was lower than the intervention expectation (β=4.485,P<0.001) and higher than baseline period (β=-2.472,P<0.001). This study found that MFR therapy was the most significant in improving soft tissue status and could effectively im-prove the range of active and passive knee joint movement;although the therapeutic effect on the comprehensive state of knee joint movement and sleep quality was poor,the fluctuation of the state tends to stabilize after intervention,which may be related to athletes' continuous high-intensity training,long-term high-frequency competitions,and inhibition of recovery. Conclu-sions:MFR therapy can effectively improve the range of motion and related soft tissue status of taekwondo athletes' knee joints,and play a role in preventing knee joint sports injuries.
myofascial release techniquemanual therapyprevention of sports injuriestaekwondo athlete
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