初次全膝关节置换后自我控制锻炼与持续被动运动的差异比较被引量：15

Self-control versus continuous passive motion exercise following primary total knee arthroplasty

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摘要背景:全膝关节置换后的功能锻炼对患者膝关节功能的恢复十分重要,持续被动运动曾经是标准的锻炼方法,但其效果饱受诟病;自我控制锻炼是患者自己控制的主动锻炼方法,同样也能达到满意的功能恢复。目的:探讨初次全膝关节置换住院期间患者自我控制功能锻炼与持续被动运动锻炼的差别。方法:纳入接受单侧初次全膝关节置换患者80例,随机分为2组,每组40例。自我控制锻炼组术后24 h开始自我控制功能锻炼;持续被动运动组术后24 h开始使用持续被动运动机开展被动功能锻炼。该研究方案已获得安徽医科大学第一附属医院伦理委员会批准,所有参与患者均被充分告知并完全知情同意。对比2组患者的一般资料、住院时间、引流量、血红蛋白水平及术后第1,3,5,7天的膝关节活动度、静息目测类比评分等指标进行评价。结果与结论:(1)2组一般资料在置换前差异无显著性意义(P> 0.05);(2)术后静息目测类比评分、术后最大伸直角度、住院时间、术后血红蛋白水平及红细胞压积差异均无显著性意义(P> 0.05);(3)术后第3天最大屈曲角度和术后第7天的膝关节周径2组差异有显著性意义(P <0.05),持续被动运动组优于自我控制锻炼组;(4)结果表明,基于患者自主控制的初次全膝关节置换后锻炼方法与传统持续被动运动锻炼效果之间无明显差别,持续被动运动可以不作为常规使用,且自主控制锻炼法完全可以满足临床需要。 BACKGROUND: Functional exercise after total knee arthroplasty is critical for the recovery of knee joint function. Continuous passive motion exercise used to be a standard exercise method, but its effect is controversial, and self-controlled exercise can achieve satisfactory functional recovery.OBJECTIVE: To explore the difference between self-control and continuous passive motion function exercise during hospitalization following total knee arthroplasty.METHODS: Eighty patients who underwent primary unilateral total knee arthroplasty were divided into two groups(n=40/group), and then underwent active self-control and continuous passive motion functional exercise at postoperative 24 hours. The study was approved by the Ethics Committee of the First Affiliated Hospital of Anhui Medical University, and all participants signed the informed consents. The baseline data, hospitalization time, drainage volume, hemoglobin level, and range of motion and Visual Analog Scale score at rest at 1, 3, 5 and 7 days post-operation were evaluated and compared between two groups.RESULTS AND CONCLUSION:(1) There was no significant difference in the baseline data between two groups(P > 0.05).(2) Postoperative Visual Analog Scale score at rest, maximum extension angle, hospitalization time, hemoglobin level and hematocrit showed no significant difference between two groups(P > 0.05).(3) The maximal flexion angle at 7 days post-operation and circumference of knee joint at 3 days post-operation in the active self-control group were significantly superior to those in the continuous passive motion group(P < 0.05).(4) These results indicate that there is no significant difference between self-control method and the traditional continuous passive motion function exercise following total knee arthroplasty. Continuous passive motion cannot be used as a routine method, and self-control function exercise can meet the clinical needs.

作者张辉刘必全李鸿刘敬军甘玉云李伦兰尹宗生 Zhang Hui;Liu Biquan;Li Hong;Liu Jingjun;Gan Yuyun;Li Lunlan;Yin Zongsheng(Department of Joint Surgery,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,Anhui Province,China;Department of Nursing,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,Anhui Province,China)

机构地区安徽医科大学第一附属医院关节外科安徽医科大学第一附属医院护理部

出处《中国组织工程研究》 CAS 北大核心 2019年第20期3130-3135,共6页 Chinese Journal of Tissue Engineering Research

基金安徽省自然科学基金(1508085MH183) 项目负责人:李伦兰安徽省高校自然科学研究项目(KJ2018A0662) 项目负责人:张辉~~

关键词初次全膝关节置换持续被动运动功能锻炼活动度疼痛引流量血容量膝关节周径 primary total knee arthroplasty continuous passive motion functional exercise range of motion pain drainage volume blood volume circumference of knee joint

分类号 R687.4 [医药卫生—骨科学]

作者简介张辉,男,1978年生,安徽省马鞍山市人,汉族,2018年安徽医科大学毕业,博士,副主任医师,主要从事关节疾病诊断与治疗方面的研究。