《中国康复理论与实践》 ›› 2022, Vol. 28 ›› Issue (9): 1096-1103.doi: 10.3969/j.issn.1006-9771.2022.09.014
马玉宝1,王晨曦2,高维广3,樊志娇1,马全胜1,孙凤龙1()
收稿日期:
2022-04-11
修回日期:
2022-07-08
出版日期:
2022-09-25
发布日期:
2022-10-08
通讯作者:
孙凤龙
E-mail:sunfenglong@ccmu.edu.cn
作者简介:
马玉宝(1983-),男,汉族,辽宁朝阳市人,博士,副教授,主要研究方向:肌骨康复,运动损伤康复。|孙凤龙(1974-),男,汉族,山东莱芜市人,硕士,主任医师,主要研究方向:关节外科与术后康复。
基金资助:
MA Yubao1,WANG Chenxi2,GAO Weiguang3,FAN Zhijiao1,MA Quansheng1,SUN Fenglong1()
Received:
2022-04-11
Revised:
2022-07-08
Published:
2022-09-25
Online:
2022-10-08
Contact:
SUN Fenglong
E-mail:sunfenglong@ccmu.edu.cn
Supported by:
摘要:
目的 观察体表感觉训练对前交叉韧带重建术(ACLR)后患者步行功能的影响。
方法 2021年1月至11月,北京康复医院ACLR后住院患者56例随机分为对照组和试验组,各28例。对照组每天常规康复训练45 min,试验组每天常规康复训练30 min、体表感觉训练15 min,共8周。干预前后检测患者足偏角和患侧足底七区冲量百分比。
结果 干预后,两组健、患侧足偏角均显著减少(t > 4.615, P < 0.001),试验组患侧足偏角更小(t = 2.263, P < 0.05)。干预后,两组足跟内侧区和足跟外侧区冲量百分比显著增加(t > 4.221, P < 0.001),试验组更高(t > 3.651, P < 0.01);两组中足区、前足中部区和前足外部区冲量百分比明显减少(t > 3.174, P < 0.01),试验组前足中部区和前足外部区冲量百分比更少(t > 2.366, P < 0.05);试验组前足内侧区和足趾区冲量百分比明显减少(t > 3.508, P < 0.01),但与对照组比较无显著性差异(t < 1.608, P > 0.05)。
结论 体表感觉训练可进一步改善ACLR后患者步行中的足偏角和患侧冲量分布,优化足底各区域负荷模式。
中图分类号:
马玉宝,王晨曦,高维广,樊志娇,马全胜,孙凤龙. 体表感觉训练对前交叉韧带重建术后患者足偏角和足底冲量的影响[J]. 《中国康复理论与实践》, 2022, 28(9): 1096-1103.
MA Yubao,WANG Chenxi,GAO Weiguang,FAN Zhijiao,MA Quansheng,SUN Fenglong. Effects of surface sensation training on foot deflection and plantar impulse after anterior cruciate ligament reconstruction[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(9): 1096-1103.
表1
两组一般资料"
项目 | 对照组 (n = 28) | 试验组 (n = 28) | χ2/t值 | P值 |
---|---|---|---|---|
性别(男/女)/n | 13/15 | 12/16 | 0.072 | 0.788 |
年龄/岁 | 30.23±7.76 | 30.43±7.43 | 0.102 | 0.919 |
身高/m | 1.69±0.09 | 1.72±0.08 | 0.660 | 0.420 |
体质量/kg | 68.60±9.68 | 69.30±11.10 | 1.614 | 0.209 |
BMI/kg·m-2 | 23.79±1.94 | 23.40±2.00 | 1.088 | 0.281 |
患病部位(左/右) /n | 11/17 | 13/15 | 0.292 | 0.589 |
术后时间(≤ 7周/> 7周) /n | 16/12 | 13/15 | 0.644 | 0.422 |
[1] | ŚMIGIELSKI R, ZDANOWICZ U, DRWIĘGA M, et al. The anatomy of the anterior cruciate ligament and its relevance to the technique of reconstruction[J]. Bone Joint J, 2016, 98B(8): 1020-1026. |
[2] |
FILBAY S R, GRINDEM H. Evidence-based recommendations for the management of anterior cruciate ligament (ACL) rupture[J]. Best Pract Res Clin Rheumatol, 2019, 33(1): 33-47.
doi: S1521-6942(19)30019-1 pmid: 31431274 |
[3] |
YAO S, FU B S, YUNG P S. Graft healing after anterior cruciate ligament reconstruction (ACLR)[J]. Asia Pac J Sports Med Arthrosc Rehabil Technol, 2021, 25: 8-15.
doi: 10.1016/j.asmart.2021.03.003 pmid: 34094881 |
[4] |
GOETZ G, DE VILLIERS C, SADOGHI P, et al. Allograft for anterior cruciate ligament reconstruction (ACLR): a systematic review and meta-analysis of long-term comparative effectiveness and safety. Results of a health technology assessment[J]. Arthrosc Sports Med Rehabil, 2020, 2(6): e873-e891.
doi: 10.1016/j.asmr.2020.07.003 |
[5] |
SLATER L V, HART J M, KELLY A R, et al. Progressive changes in walking kinematics and kinetics after anterior cruciate ligament injury and reconstruction: a review and meta-analysis[J]. J Athl Train, 2017, 52(9): 847-860.
doi: 10.4085/1062-6050-52.6.06 |
[6] |
BUCKTHORPE M, DANELON F, LA ROSA G, et al. Recommendations for hamstring function recovery after ACL reconstruction[J]. Sports Med, 2020, 51(4): 607-624.
doi: 10.1007/s40279-020-01400-x |
[7] |
PANG M, YANG L, OUYANG H, et al. Dual-task exercise reduces cognitive-motor interference in walking and falls after stroke[J]. Stroke, 2018, 49(12): 2990-2998.
doi: 10.1161/STROKEAHA.118.022157 pmid: 30571419 |
[8] |
MIKO S C, SIMON J E, MONFORT S M, et al. Postural stability during visual-based cognitive and motor dual-tasks after ACLR[J]. J Sci Med Sport, 2021, 24(2): 146-151.
doi: 10.1016/j.jsams.2020.07.008 pmid: 32773174 |
[9] | VAN DE WINCKEL A, DE PATRE D, RIGONI M, et al. Exploratory study of how Cognitive Multisensory Rehabilitation restores parietal operculum connectivity and improves upper limb movements in chronic stroke[J]. Sci reports, 2020, 10(1): 1-11. |
[10] |
GIORDANO K, CHAPUT M, ANZ A, et al. Knee kinetics in baseball hitting and return to play after ACL reconstruction[J]. Int J Sports Med, 2021, 42(9): 847-852.
doi: 10.1055/a-1236-4102 |
[11] |
GUIOTTO A, CINIGLIO A, SPOLAOR F, et al. Reliability and repeatability of ACL quick check: a methodology for on field lower limb joint kinematics and kinetics assessment in sport applications[J]. Sensors (Basel), 2021, 22(1): 259.
doi: 10.3390/s22010259 |
[12] | MARZETTI E, RABINI A, PICCININI G, et al. Neurocognitive therapeutic exercise improves pain and function in patients with shoulder impingement syndrome: a single-blind randomized controlled clinical trial[J]. Eur J Phys Rehabil Med, 2014, 50(3): 255. |
[13] |
PARK J. The effects of plantar perception training on balance and falls efficacy of the elderly with a history of falls: a single-blind, randomized controlled trial[J]. Arch Gerontol Geriatr, 2018, 77: 19-23.
doi: 10.1016/j.archger.2018.03.014 |
[14] |
NAKANO H, NOZAKI M, UETA K, et al. Effect of a plantar perceptual learning task on walking stability in the elderly: a randomized controlled trial[J]. Clin Rehabil, 2013, 27(7): 608-615.
doi: 10.1177/0269215512471062 pmid: 23405022 |
[15] | 姜焯文. 基于静动态平衡能力的人体稳定性评价方法研究[D]. 天津: 天津科技大学, 2020. |
JIANG Z W. Study on the method of human stability evaluation based on the static and dynamic balance[D]. Tianjin: Tianjin University of Science and Technology, 2020. | |
[16] | 曹方园, 徐俊凯, 胡海, 等. 跑步时足偏角对胫骨冲击影响的探索性研究[J]. 医用生物力学, 2019, 34(2): 207-212. |
CAO F Y, XU J K, HU H, et al. Exploration study about influence of foot progression angle on tibial shock during running[J]. J Med Biomed, 2019, 34(2): 207-212. | |
[17] | 潘永雄, 陈锦, 王大伟, 等. 足底压力测试系统的常用步态分析指标[J]. 临床医学工程, 2018, 25(9): 1267-1269. |
PAN Y X, CHEN J, WANG D W, et al. The common gait analysis indicators of plantar pressure system[J]. Clin Med Engineer, 2018, 25(9): 1267-1269. | |
[18] | 顾琳燕, 邱华平, 张晟宇, 等. 正常人群步行足偏角与年龄特征分析[J]. 生物医学工程学杂志, 2018, 35(1): 45-48. |
GU L Y, QIU H P, ZHANG S Y, et al. Analysis of the relevance of age and toe out angle of normal adults' gait[J]. J Biomed Engineer, 2018, 35(1): 45-48. | |
[19] | 吴剑, 李建设. 人体行走时步态的生物力学研究进展[J]. 中国运动医学杂志, 2002(3): 305-307. |
WU J, LI J S. Progress in biomechanics of human gait during walking[J]. Chin J Sports Med, 2002(3): 305-307. | |
[20] |
TAZAWA M, SOHMIYA M, WADA N, et al. Toe-out angle changes after total knee arthroplasty in patients with varus knee osteoarthritis[J]. Knee Surg Sports Traumatol Arthrosc, 2014, 22(12): 3168-3173.
doi: 10.1007/s00167-014-2841-8 |
[21] |
BEHLING A V, MANZ S, VON TSCHARNER V, et al. Pronation or foot movement: what is important[J]. J Sci Med Sport, 2020, 23(4): 366-371.
doi: 10.1016/j.jsams.2019.11.002 |
[22] | 黄红拾, 敖英芳, 郭秦炜, 等. 前交叉韧带重建术影响步行时足底压力时相特征初步研究[J]. 中国运动医学杂志, 2014, 33(3): 189-192. |
HUANG H S, AO Y F, GUO Q W, et al. Preliminary study on the change in temporal plantar pressure during walking after ACL reconstruction[J]. Chin J Sports Med, 2014, 33(3): 189-192. | |
[23] | 李玉周, 王婧怡, 胡英琪. 前交叉韧带重建术后短期足底压力分布及平衡特征研究[J]. 体育科学, 2020, 40(5): 52-59. |
LI Y Z, WANG J Y, HU Y Q. Short-term plantar pressure distribution and balance after anterior cruciate ligament reconstruction[J]. Sports Sci, 2020, 40(5): 52-59. | |
[24] | 杜天舒, 成西侠, 张春礼, 等. 前交叉韧带损伤患者动态足底压力变化[J]. 中国运动医学杂志, 2016, 35(6): 520-526. |
DU T S, CHENG X X, ZHANG C L, et al. Change in plantar pressure of patients with anterior cruciate ligament deficient during walking[J]. Chin J Sports Med, 2016, 35(6): 520-526. | |
[25] | 黄浩然, 陈俊, 王思哲, 等. 足部空间姿态评估分析系统在ACL重建前后步态分析中的应用[J]. 中国骨与关节损伤杂志, 2018, 33(12): 1255-1258. |
HAUNG H R, CHEN J, WANG S Z, et al. Analysis of gait before and after anterior cruciate ligament reconstruction using foot space pose assessment system[J]. Chin J Bone Joint Injury, 2018, 33(12): 1255-1258. | |
[26] | 张燊. 足部功能训练对足弓形态及跑步生物力学影响的研究[D]. 上海: 上海体育学院, 2020. |
ZHANG S. The effects of the functional foot exercise on the arch shape and running biomechanics[D]. Shanghai: Shanghai University of Sport, 2020. | |
[27] |
ZHANG Z, WANG L, HU K, et al. Characteristics of plantar loads during walking in patients with knee osteoarthritis[J]. Med Sci Monit, 2017, 23: 5714-5719.
doi: 10.12659/MSM.905136 |
[28] |
GENC Y, GULTEKIN A, DUYMUS T M, et al. Pedobarography in the assessment of postoperative calcaneal fracture pressure with gait[J]. J Foot Ankle Surg, 2016, 55(1): 99-105.
doi: 10.1053/j.jfas.2015.07.018 pmid: 26364236 |
[29] |
REES H W. Management of osteoarthritis of the hip[J]. J Am Acad Orthop Surg, 2020, 28(7): e288-e291.
doi: 10.5435/JAAOS-D-19-00416 |
[30] |
LEE S, BAE S, JEON D, et al. The effects of cognitive exercise therapy on chronic stroke patients' upper limb functions, activities of daily living and quality of life[J]. J Phys Ther Sci, 2015, 27(9): 2787-2791.
doi: 10.1589/jpts.27.2787 pmid: 26504294 |
[31] | DE PATRE D, VAN DE WINCKEL A, PANTÉ F, et al. Visual and motor recovery after "Cognitive Therapeutic Exercises" in cortical blindness: a case study[J]. J Neur Phys Ther, 2017, 41(3): 164-172. |
[32] |
MORIOKA S, FUJITA H, HIYAMIZU M, et al. Effects of plantar perception training on standing posture balance in the old old and the very old living in nursing facilities: a randomized controlled trial[J]. Clin Rehabil, 2011, 25(11): 1011-1020.
doi: 10.1177/0269215510395792 pmid: 21504952 |
[33] |
NAKANO H, NOZAKI M, UETA K, et al. Effect of a plantar perceptual learning task on walking stability in the elderly: a randomized controlled trial[J]. Clin Rehabil, 2013, 27(7): 608-615.
doi: 10.1177/0269215512471062 pmid: 23405022 |
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