摘要
目的探讨反重力跑台系统在前交叉韧带重建术(ACLR)术后患者步行训练中的应用效果。方法回顾性分析2020年10月至2022年5月于海军青岛特勤疗养中心行康复治疗的ACLR术后患者,选取符合纳入排除标准的40例患者,以随机数字表法分为观察组和对照组各20例。纳入标准:单侧前交叉韧带(ACL)损伤合并半月板损伤,首次受伤后4~5周行ACLR,术后1周开始康复治疗。排除标准:陈旧性ACL损伤,膝关节手术史,合并后交叉韧带损伤及侧副韧带损伤、下肢骨折等,认知功能障碍及心血管系统疾病。两组患者康复训练时间均为8周。对照组给予常规的步行训练,观察组利用反重力跑台系统行减重步行训练。采用Isoforce等速肌力康复评估系统进行主动关节角度重现偏差度测试、德国Steinbichler三维步态分析系统对两组患者进行步态分析、Lysholm评分对两组患者进行评定。计数资料使用频数进行描述,卡方检验分析,正态分布的计量资料以(x^(-)±s)描述,采用重复测量方差分析。结果术后第8、12周观察组Lysholm评分优于对照组,差异有统计学意义(t=14.630、8.568,均为P<0.05)、主动关节角度重现偏差度优于对照组,差异有统计学意义(30°:t=5.273、5.410,60°:t=4.420、3.934,均为P<0.05)、步态分析评分优于对照组,差异有统计学意义(步长:t=5.704,7.780;步频:t=8.270、5.725,步速:t=6.068、2.758,均为P<0.05)。结论反重力跑台系统减重步行训练可改善ACLR术后患者的膝关节功能及本体感觉,是一种能提升ACLR术后患者步行能力的有效方法。
Objective To explore the application effect of anti-gravity treadmill system in walking training of patients after anterior cruciate ligament reconstruction(ACLR).Methods From October 2020 to May 2022,40 patients with ACLR who underwent rehabilitation treatment in Naval Qingdao Special Service Rehabilitation Center were selected and divided into observation group and control group by random number table method,with 20 cases in each group.Inclusion criteria:the patients who have unilateral anterior cruciate ligament(ACL)injury combining meniscus injury,accept ACLR four to five weeks after injury,and start rehabilitation at one week after surgery.Exclusion criteria:old ACL injury,knee surgery history,combining posterior cruciate ligament and collateral ligaments injuries and lower limb fractures etc.,cognitive dysfunctions and cardiovascular diseases The rehabilitation training time of the two groups was eight weeks.Patients in the control group were given routine walking training,while patients in the observation group were given walking training with anti-gravity treadmill system.The isoforce isokinetic muscle strength rehabilitation evaluation system was used for active joint angle reproducibility deviation test,the German Steinbichler three-dimensional gait analysis system was used for gait analysis,and the Lysholm score was used to evaluate the two groups of patients.The count data were described by frequency,the difference was analyzed by chi square analysis,and the measurement data of normal distribution were described by(x^(-)±s),and analysed by repeated measures ANOVA.Results The Lysholm score of the observation group was better than that of the control group at eight and 12 weeks after operation,and the differences were statistically significant(t=14.630,8.568,both P<0.05).The active joint angle recurrence deviation was better than that of the control group,and the differences were statistically significant(30°:t=5.273,5.410;60°:t=4.420,3.934,all P<0.05).Gait analysis score of the experimental group were better than those of the control group,and the differences were statistically significant(step length:t=5.704,7.780;stride frequency:t=8.270,5.725;gait speed:t=6.068,2.758;all P<0.05).Conclusions Weight-loss walking training with anti-gravity treadmill system can improve the knee joint function and proprioception of patients after ACLR.It is an effective method to improve the walking ability of patients after ACLR.
作者
郭春花
徐晓燕
何劼
刘晓洁
孟庆芳
杨曦
江珉
刘铁成
Guo Chunhua;Xu Xiaoyan;He Jie;Liu Xiaojie;Meng Qingfang;Yang Xi;Jiang Min;Liu Tiecheng(Navy Qingdao Special Service Recuperation Center,Qingdao 266000,China;Orthopedic Hospital Affiliated to the 920th Hospital of Joint Service Forces of PLA,Kunming 650032,China)
出处
《中华关节外科杂志（电子版）》
CAS
CSCD
2023年第4期485-491,共7页
Chinese Journal of Joint Surgery(Electronic Edition)
基金
云南省创伤骨科临床医学中心(zx20191001)
关键词
前交叉韧带重建
重力
改变
步行
Anterior cruciate ligament reconstruction
Gravity,altered
Walking
作者简介
通信作者:江珉,Email:xxyljy2007527@163.com
