摘要
目的探讨膝关节损伤术后患者运动功能障碍与平衡功能指标之间的相关性,为膝关节损伤患者康复方案提供依据.方法选取2020年9月—2022年1月于上海市第二康复医院进行康复的37例单侧膝关节损伤术后患者为患者组,选取健康职工37例为对照组.选取静态平衡仪采集蹲踞测试、改良临床平衡感觉整合测试、稳定极限测试、步行测试等四项测试中的静态重心摆动速度、随意运动反应时间、自动态重心摆动速度、端点行程、最大位移及自动态方向控制的数据,采用膝关节损伤和骨关节炎评分表(KOOS)评估受试者的运动及娱乐功能,分析平衡测试数据与KOOS功能及娱乐能力评分的相关性.结果患者组的双下肢对称性差值均明显高于对照组,组间差异有统计学意义(P<0.05).患者组KOOS功能及娱乐能力评分与端点行程呈高度正相关(r=0.904,P<0.01),与最大位移呈高度正相关(r=0.869,P<0.01),与自动态重心地面投影点摆动速度呈正相关(r=0.414,P<0.05),与随意运动反应时间呈负相关(r=-0.443,P<0.05).结论膝关节损伤术后患者的平衡功能缺陷是引起运动功能障碍的重要因素之一,主要表现为自主运动控制不足,且健侧肢体代偿会阻碍患侧肢体功能的发挥.这提示康复治疗中需加强自主运动控制方面的训练,还需减少健侧肢体的过度代偿作用.
Objective To explore the correlation between motor dysfunction and balance function indexes in patients with knee injury after surgery,and to provide evidence for rehabilitation of patients with knee injury.Methods 37 patients with unilateral knee injury who underwent rehabilitation in the Second Rehabilitation Hospital of Shanghai from September 2020 to January 2022 were selected as the patient group,while 37 healthy workers were selected as the control group.Static balance instrument was selected to collect the data of static center of gravity swing speed,voluntary motion response time,self-dynamic center of gravity swing speed,endpoint stroke,maximum displacement and self-dynamic direction control in weight bearing squat test,modified clinical test of sensory interaction on balance test,limits of stability test and walk across test.The knee injury and osteoarthritis outcome score(KOOS)was used to evaluate the exercise and recreational function of the subjects.The correlation between balance test data and KOOS function and recreation ability scores were analyzed.Results The symmetry differences of both lower limbs in the patient group were significantly higher than those in the control group,and the differences between the groups were statistically significant(P<0.05).KOOS function and recreational ability scores in the patient group were highly positively correlated with endpoint travel(r=0.904,P<0.01),maximum displacement(r=0.869,P<0.01),and swing velocity of the self-dynamic center of gravity(r=0.414,P<0.05),while there was a negative correlation with voluntary motor reaction time(r=-0.443,P<0.05).Conclusion Balance dysfunction is one of the important factors that cause motor dysfunction in patients after knee injury.It is mainly manifested as lack of autonomic motor control,and compensation of healthy limb may hinder the function of affected limb.This suggests that the training of autonomous motor control should be strengthened in rehabilitation treatment,and the excessive compensatory effect of healthy limbs should be reduced.
作者
黄春萌
姜蓉
HUANG Chunmeng;JIANG Rong(Department of Physical Therapy,The Second Rehabilitation Hospital of Shanghai,Shanghai,200441,China;Osteoarthropathy Rehabilitation Ward,The Second Rehabilitation Hospital of Shanghai,Shanghai,200441,China)
出处
《反射疗法与康复医学》
2023年第8期74-77,共4页
Reflexology And Rehabilitation Medicine
基金
宝山区医学特色专科-骨关节康复科(BSZK-2019-C08)
上海市宝山区医学卫生项目(20-E-44)。
关键词
运动损伤
前后交叉韧带损伤
半月板损伤
膝关节手术
平衡功能测试
稳定极限
本体感觉
Sports injury
Posterior and anterior cruciate ligament injury
Meniscus injury
Knee surgery
Functional balance test
Limits of stability
Proprioceptive sense
作者简介
黄春萌(1994-),男,江苏南通人,本科,中级康复治疗师,研究方向:肌骨疼痛康复;通信作者:姜蓉(1985-),女,湖北武汉人,硕士研究生,副主任医师,研究方向:肌骨疼痛康复,邮箱:284452079@qq.com。
