《中国康复理论与实践》

《中国康复理论与实践》

• 临床研究 • 上一篇    下一篇

自身肌力标准指导功能训练在全膝关节置换术后早期康复中的应用①

朱姝，杨礼庆   

  1. 中国医科大学附属盛京医院骨科，辽宁沈阳市110004。
  • 出版日期:2016-06-25 发布日期:2016-07-04

Functional Exercise Guided by Self Muscle Strength Standard for Early Rehabilitation after Total Knee Arthroplasty

ZHU Shu, YANG Li-qing   

  1. Department of Spine and Joint, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China
  • Published:2016-06-25 Online:2016-07-04

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摘要： 目的观察自身肌力标准指导功能训练在全膝关节置换术(TKA)后早期临床康复训练中的效果。方法2014 年9 月~2015 年9 月在本科室进行单侧TKA后患者62 例，随机分为实验组(n=31)和对照组(n=31)。对照组给予临床常规的康复综合训练，实验组给予自身肌力标准指导下的康复综合训练。比较术后7 d 膝关节肿胀、疼痛程度，术后7 d、15 d 肌力情况，术后15 d 膝关节活动度、美国膝关节协会评分(KSS)以及术后住院时间。结果两组术前各项评分均无显著性差异(t<0.960, P>0.05)，术后均明显提高(t>3.470, P<0.01)。术后7 d，两组视觉模拟评分无显著性差异(t=1.800, P=0.077)，患膝髌骨中点和腓肠肌最粗点的周径差无显著性差异(t=0.840, P=0.404)。术后7 d、15 d，实验组股四头肌肌力评分均高于对照组(t>2.280, P<0.05)。术后15 d，两组膝关节活动度、KSS膝评分均无显著性差异(t>0.850, P>0.05)；实验组KSS功能评分显著高于对照组(t=5.870, P<0.001)。实验组术后住院时间明显短于对照组(t=7.65, P<0.01)。结论自身肌力标准指导的功能训练能增加TKA后下肢肌力和膝关节功能，缩短住院天数。

关键词: 全膝关节置换术, 肌力标准, 功能训练, 术后康复

Abstract: Objective To observe the effect of functional exercise guided by self muscle strength in early rehabilitation on patients after total knee arthroplasty (TKA). Methods From September, 2014 to September, 2015, 62 patients after TKA were randomly divided into experimental group (n=31) and control group (n=31). The control group received conventional rehabilitation training, while the experimental group received rehabilitation training under the guidance of their own muscle strength standard. The degrees of swelling and pain seven days after TKA; the muscle strength seven and 15 days after TKA; the range of motion (ROM), the Keen Society Score (KSS) 15 days after TKA; and the postoperative hospital stay were compared. Results There was no significant difference in all the indexes above between two groups before TKA (t<0.960, P>0.05), and all of them improved after TKA (t>3.470, P<0.01). There was no significant difference in the degrees of swelling (t=1.800, P=0.077) and pain (t=0.840, P=0.404) seven days after TKA. The score of quadriceps strength was higher in the experiment group than in the control group (t>2.280, P<0.05) seven and 15 days after TKA. There was no significant difference in the ROM of the knee and the score of knee between two groups (t>0.850, P>0.05), and the functional score was higher in the experiment group than in the control group (t=5.870, P<0.001) 15 days after TKA. The postoperative hospital stay was shorter in the experiment group (t=7.65, P< 0.01). Conclusion Functional exercise under the guidance of their own muscle strength standard could contribute to the improvement of postoperative muscle strength and knee joint function, and shorten the hospitalization stay.

Key words: total knee arthroplasty, muscle strength standard, functional exercise, postoperative rehabilitation