术前奥塔戈运动对人工膝关节置换术患者功能锻炼的干预效果
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摘要
目的探讨术前奥塔戈运动对人工膝关节置换术患者功能锻炼的干预效果。方法便利抽样选取西京医院2016年10月至2017年10月行全膝关节置换术治疗的患者61例。采用随机数字的方法分为对照组(31例)和干预组(30例)。对照组采用常规骨科护理,干预组在对照组基础上实施术前奥塔戈运动计划,对比两组患者的功能锻炼干预效果。结果干预前,对照组与干预组患者膝关节屈曲度无显著差异(P>0.05);术后3d,对照组与干预组患者膝关节屈曲度无显著差异(P>0.05);术后7、14d,干预组患者膝关节屈曲度显著高于对照组,差异有统计学意义(均P<0.05)。术后14d,干预组患者的纽约特种外科医院膝关节评分(hospital for special surgery knee score,HSS)、Barthel评分均显著高于对照组,差异有统计学意义(P<0.05)。干预前,对照组与干预组的MFES评分无显著差异(P>0.05);术后30d,干预组跌倒效能量表(modified falls efficacy scale,MFES)得分显著高于对照组,差异有统计学意义(P<0.05)。结论奥塔戈运动训练对改善患者膝关节屈曲度、膝关节功能以及日常生活功能有显著的临床意义,并有助于减少跌倒的发生,值得临床推广使用。
Objective To investigate the intervention effect of preoperative Otago exercise on functional capacity in patients with total knee arthroplasty.Methods By convenience sampling,61 cases with total knee arthroplasty in our hospital from October 2016 to October 2017 were selected.The patients were divided into the control group(31 cases)and the intervention group(30 cases)by random number method.The control group received routine orthopedic nursing care,and the intervention group received preoperative Otago exercise on the basis of the control group.The effect of the functional exercise intervention was compared in two groups.Results Before the intervention,there was no significant difference in knee flexion between the control group and the intervention group(P>0.05).Three days after surgery,the knee flexion between the control group and the intervention group had no significant difference(P>0.05).At 7 and 14 days after surgery,the knee flexion of intervention group was significantly higher than that of control group,which the difference was statistically significant(all P<0.05).At 14 days after surgery,the HSS and Barthel scores of intervention group were significantly higher than those of control group(P<0.05).Before intervention,there was no significant difference in MFES score between the control group and the intervention group(P>0.05).At 30 days after surgery,MFES score of the intervention group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).Conclusions Otago exercise training has clinical significance in improving patients' knee flexion,knee joint function and daily living,and can reduce the incidence of falls,which is worthy of clinical application.
Objective To investigate the intervention effect of preoperative Otago exercise on functional capacity in patients with total knee arthroplasty.Methods By convenience sampling,61 cases with total knee arthroplasty in our hospital from October 2016 to October 2017 were selected.The patients were divided into the control group(31 cases)and the intervention group(30 cases)by random number method.The control group received routine orthopedic nursing care,and the intervention group received preoperative Otago exercise on the basis of the control group.The effect of the functional exercise intervention was compared in two groups.Results Before the intervention,there was no significant difference in knee flexion between the control group and the intervention group(P>0.05).Three days after surgery,the knee flexion between the control group and the intervention group had no significant difference(P>0.05).At 7 and 14 days after surgery,the knee flexion of intervention group was significantly higher than that of control group,which the difference was statistically significant(all P<0.05).At 14 days after surgery,the HSS and Barthel scores of intervention group were significantly higher than those of control group(P<0.05).Before intervention,there was no significant difference in MFES score between the control group and the intervention group(P>0.05).At 30 days after surgery,MFES score of the intervention group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).Conclusions Otago exercise training has clinical significance in improving patients' knee flexion,knee joint function and daily living,and can reduce the incidence of falls,which is worthy of clinical application.
引文
[1]白文斌.膝关节置换手术后短期内并发症与翻修状况分析[J].检验医学与临床,2017,14(7):954-956.
[2]Campbell A,Robertson M.Otago exercise programme to prevent falls in older adults:a home-based,individually tailored strength and balance retraining programme[EB/OL].[2017-08-09].https://www.mendeley.com/research-papers/otago-exercise-programme-prevent-fallsolder-adults-homebased-individually-tailored-strengthbalance/.
[3]闫欣,石贞仙.人工全膝关节置换术后患膝伸直障碍的影响因素分析[J].国际护理学杂志,2017,36(7):869-873.
[4]孙艳春.人工全膝关节置换术后早期康复训练对关节功能恢复的影响分析[J].中国医药指南,2017,15(28):124-125.
[5]TOMAEVI T S,KOPANSKI S,MIKOV A,et al.Functional status of patients after stroke[J].Medicinski Pregled,2015,37(28):2013-2017.
[6]WADHWA D,HANDE D.Effectiveness of otago exercise program on reducing the fall risk in elderly:single case report[J].J Interdiscipl Res,2016,12(33):536-539.
[7]赵小宁,柴恺.人工全膝关节置换术术前功能锻炼的研究进展[J].上海护理,2017,17(2):68-71.
[8]李寰,智冬梅,石磊,等.奥塔戈运动对脑出血后遗运动障碍老年患者运动能力和跌倒效能的影响[J].护理学报,2016,23(10):44-48.
[9]金凤琴,于素贞,辛庆锋.奥塔戈运动对老年脑梗死患者跌倒效能和生活质量的影响[J].现代医药卫生,2017,32(15):2368-2369.
[10]于彤,王玉,芦英洁,等.居家不出老年人奥塔戈运动锻炼项目的实施[J].护理学杂志,2017,32(17):87-90.
[11]裴子文,陈建.奥塔戈运动项目在社区康复中应用进展[J].饮食保健,2017,4(10):285.
[12]孙林霞,王玉芳.延续性护理模式对脑卒中患者巴塞尔指数影响的效果观察[J].护士进修杂志,2016,31(3):242-245.
[13]李付元,冯世庆,周恒星,等.人工全膝关节置换术治疗膝关节骨关节炎的疗效观察[J].山东医药,2014,54(5):71-73.
[14]郝燕萍,刘雪琴.修订版跌倒效能量表在我国老年人群中的测试研究[J].中华护理杂志,2007,42(1):19-21.
[15]薛翌蔚,钱燕,董文君,等.多媒体健康教育在全膝关节置换术病人康复治疗中的应用[J].护理研究,2016,30(20):2489-2491.
[16]薛晓华,许建中.术前膝关节活动度对TKA术后关节功能的影响[J].河南医学研究,2014,23(2):98-100.
[17]杨虹,赵巧玉.奥塔戈运动在老年全髋关节置换术患者出院后跌倒管理中的应用[J].护理管理杂志,2016,16(3):192-194.
[18]李颖,张晓萍,周雪琴,等.术前教育功能锻炼指导对膝关节置换术后康复的影响[J].中国医药指南,2011,9(30):176-177.
[19]汤舜銮,李惠卿,洪瑜玲,等.早期康复干预对人工全膝关节置换术手术肢体功能恢复的影响[J].现代临床护理,2010,9(1):4-5.
[20]唐浪娟,岳丽春,刘聪香,等.奥塔戈运动对帕金森出院患者害怕跌倒心理及平衡能力的影响[J].中国康复医学杂志,2016,31(12):1383-1385.
[21]李莺,程云.奥塔戈运动项目对老年脑卒中患者跌倒的影响[J].护理学杂志,2014,29(21):1-4.
[2]Campbell A,Robertson M.Otago exercise programme to prevent falls in older adults:a home-based,individually tailored strength and balance retraining programme[EB/OL].[2017-08-09].https://www.mendeley.com/research-papers/otago-exercise-programme-prevent-fallsolder-adults-homebased-individually-tailored-strengthbalance/.
[3]闫欣,石贞仙.人工全膝关节置换术后患膝伸直障碍的影响因素分析[J].国际护理学杂志,2017,36(7):869-873.
[4]孙艳春.人工全膝关节置换术后早期康复训练对关节功能恢复的影响分析[J].中国医药指南,2017,15(28):124-125.
[5]TOMAEVI T S,KOPANSKI S,MIKOV A,et al.Functional status of patients after stroke[J].Medicinski Pregled,2015,37(28):2013-2017.
[6]WADHWA D,HANDE D.Effectiveness of otago exercise program on reducing the fall risk in elderly:single case report[J].J Interdiscipl Res,2016,12(33):536-539.
[7]赵小宁,柴恺.人工全膝关节置换术术前功能锻炼的研究进展[J].上海护理,2017,17(2):68-71.
[8]李寰,智冬梅,石磊,等.奥塔戈运动对脑出血后遗运动障碍老年患者运动能力和跌倒效能的影响[J].护理学报,2016,23(10):44-48.
[9]金凤琴,于素贞,辛庆锋.奥塔戈运动对老年脑梗死患者跌倒效能和生活质量的影响[J].现代医药卫生,2017,32(15):2368-2369.
[10]于彤,王玉,芦英洁,等.居家不出老年人奥塔戈运动锻炼项目的实施[J].护理学杂志,2017,32(17):87-90.
[11]裴子文,陈建.奥塔戈运动项目在社区康复中应用进展[J].饮食保健,2017,4(10):285.
[12]孙林霞,王玉芳.延续性护理模式对脑卒中患者巴塞尔指数影响的效果观察[J].护士进修杂志,2016,31(3):242-245.
[13]李付元,冯世庆,周恒星,等.人工全膝关节置换术治疗膝关节骨关节炎的疗效观察[J].山东医药,2014,54(5):71-73.
[14]郝燕萍,刘雪琴.修订版跌倒效能量表在我国老年人群中的测试研究[J].中华护理杂志,2007,42(1):19-21.
[15]薛翌蔚,钱燕,董文君,等.多媒体健康教育在全膝关节置换术病人康复治疗中的应用[J].护理研究,2016,30(20):2489-2491.
[16]薛晓华,许建中.术前膝关节活动度对TKA术后关节功能的影响[J].河南医学研究,2014,23(2):98-100.
[17]杨虹,赵巧玉.奥塔戈运动在老年全髋关节置换术患者出院后跌倒管理中的应用[J].护理管理杂志,2016,16(3):192-194.
[18]李颖,张晓萍,周雪琴,等.术前教育功能锻炼指导对膝关节置换术后康复的影响[J].中国医药指南,2011,9(30):176-177.
[19]汤舜銮,李惠卿,洪瑜玲,等.早期康复干预对人工全膝关节置换术手术肢体功能恢复的影响[J].现代临床护理,2010,9(1):4-5.
[20]唐浪娟,岳丽春,刘聪香,等.奥塔戈运动对帕金森出院患者害怕跌倒心理及平衡能力的影响[J].中国康复医学杂志,2016,31(12):1383-1385.
[21]李莺,程云.奥塔戈运动项目对老年脑卒中患者跌倒的影响[J].护理学杂志,2014,29(21):1-4.
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