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

doi:10.3969/j.issn.1006-9771.2022.09.014

《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

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

马玉宝¹,王晨曦²,高维广³,樊志娇¹,马全胜¹,孙凤龙¹()

1.首都医科大学附属北京康复医院肌骨康复中心,北京市 100144
2.北京德尔康尼骨科医院,北京市 100144
3.沈阳体育学院研究生工作部,辽宁沈阳市 110102

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:
首都医科大学科研培育基金项目(PYZ19073);首都医科大学附属北京康复医院科研发展专项-博士科研基金专项(2021-003)

Effects of surface sensation training on foot deflection and plantar impulse after anterior cruciate ligament reconstruction

MA Yubao¹,WANG Chenxi²,GAO Weiguang³,FAN Zhijiao¹,MA Quansheng¹,SUN Fenglong¹()

1. Musculoskeletal Rehabilitation Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing 100144, China
2. Beijing DCN Orthopaedic Hospital, Beijing 100144, China
3. Graduate Department, Shenyang Sport University, Shenyang, Liaoning 110102, China

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:
Capital Medical University Research Fund(PYZ19073);Research and Development Fund of Beijing Rehabilitation Hospital, Capital Medical University(2021-003)

摘要/Abstract

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。

关键词: 前交叉韧带重建术, 体表感觉训练, 步行, 足偏角, 冲量

Abstract:

Objective To observe the effect of surface sensation training on walking function of patients after anterior cruciate ligament reconstruction (ACLR).
Methods From January to November, 2021, 56 ACLR inpatients in Beijing Rehabilitation Hospital were randomly divided into control group (n = 28) and experimental group (n = 28). The control group received routine rehabilitation training of 45 minutes a time, while the experimental group received routine rehabilitation training of 30 minutes and surface sensation training of 15 minutes a time, for eight weeks. Their toe-out angle and affected side impulse percentage of plantar seven zones were measured before and after intervention.
Results The toe-out angle of both the healthy and the affected sides decreased in both groups after intervention (t > 4.615, P < 0.001), and it was less in the affected side in the experimental group (t = 2.263, P < 0.05). The impulse percentage in heel medial and heel lateral areas increased in both groups after intervention (t > 4.221, P< 0.001), and it was more in the experimental group (t > 3.651, P< 0.01); while the impulse percentage in middle foot, foot intermediate and foot lateral areas decreased in both groups (t > 3.174, P < 0.01), and it was less in foot intermediate and foot lateral areas in the experimental group (t > 2.366, P< 0.05); the impulse percentage decreased in foot medial and toe areas in the experimental group (t > 3.508, P < 0.01), but there was no significant difference between two groups (t < 1.608, P > 0.05).
Conclusion Surface sensation training can further improve the foot deflection and distribution of impulse of affected side in patients after ACLR during walking, to normalize the load patterns.

Key words: anterior cruciate ligament reconstruction, surface sensation training, walking, toe-out angle, impulse

中图分类号:

R686

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.

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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

组别	n	干预前	干预后	t值	P值
对照组	28	12.26±3.65	9.94±1.96	4.615	< 0.001
试验组	28	13.20±2.42	9.49±2.51	9.490	< 0.001
t值		1.179	0.779
P值		0.243	0.439

组别	n	干预前	干预后	t值	P值
对照组	28	14.14±3.25	11.21±2.19	5.561	< 0.001
试验组	28	14.48±3.52	9.69±2.29	8.793	< 0.001
t值		0.388	2.623
P值		0.699	0.011

组别	n	干预前	干预后	t值	P值
对照组	28	13.54±2.51	15.61±2.77	4.221	< 0.001
试验组	28	13.23±3.33	19.13±2.97	24.603	< 0.001
t值		0.414	4.749
P值		0.680	< 0.001

组别	n	干预前	干预后	t值	P值
对照组	28	11.03±2.27	15.61±2.94	12.624	< 0.001
试验组	28	11.75±3.65	18.51±3.22	20.377	< 0.001
t值		0.920	3.651
P值		0.362	0.001

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

Effects of surface sensation training on foot deflection and plantar impulse after anterior cruciate ligament reconstruction

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组别	n	干预前	干预后	t值	P值
对照组	28	14.96±4.99	11.18±5.49	7.676	< 0.001
试验组	28	13.89±5.17	9.83±5.08	15.434	< 0.001
t值		0.811	0.990
P值		0.420	0.362

组别	n	干预前	干预后	t值	P值
对照组	28	11.21±2.43	10.56±2.51	1.655	0.190
试验组	28	12.64±3.68	9.45±2.84	9.795	< 0.001
t值		1.773	1.608
P值		0.081	0.113

组别	n	干预前	干预后	t值	P值
对照组	28	28.00±3.10	26.64±2.74	3.174	0.004
试验组	28	27.01±3.62	24.35±3.01	9.551	< 0.001
t值		1.136	3.080
P值		0.260	0.003

组别	n	干预前	干预后	t值	P值
对照组	28	12.81±1.44	10.54±1.82	7.915	< 0.001
试验组	28	12.61±2.29	9.44±1.79	10.348	< 0.001
t值		0.401	2.366
P值		0.690	0.021

组别	n	干预前	干预后	t值	P值
对照组	28	8.88±4.04	9.29±3.63	1.153	0.136
试验组	28	8.46±3.61	9.86±3.31	3.508	0.001
t值		0.424	0.632
P值		0.673	0.530

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