神经肌肉关节促进法(NJF)技术对膝关节功能障碍康复的影响
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摘要
目的:研究神经肌肉关节促进技术(NJF)直接应用在膝关节功能障碍康复中的临床效果。方法:非运动员单侧膝关节功能障碍患者45例,随机分为实验组、对照组1和对照组2三组,每组各15人,均进行常规治疗。实验组增加NJF治疗,对照组1增加关节松动术和本体感觉神经肌肉促进法(PNF),对照组2增加关节松动术。并分别在4周、8周、12周进行膝关节主/被动角度、疼痛目测类比评分法(VAS)、Lysholm膝关节功能评分对比研究。结果:组内对比,实验组相邻时间点的VAS评定对比有统计学意义(P<0.01),除8周和12周时间点对比无统计学意义(P>0.05)外,主/被活动度、Lysholm评定其他相邻时间点对比有统计学意义(P<0.05,AROM/PROM,P<0.01,Lysholm)。组间对比:(1)主/被动活动度,实验组与对照组1对比4、8周主动活动度和4周被动活动度有统计学意义(P<0.05),12周主动活动和8、12周被动活动度无统计学意义(P>0.05),实验组、对照组1分别与对照组2对比4、8周有统计学意义(P<0.05)。(2)VAS评分,4周时实验组分别与对照组1、对照组2对比无统计学意义(P>0.05),8、12周时有统计学意义(P<0.01,8周,P<0.05,12周)。(3)Lysholm评定,4、8周时,实验组与对照组1对比有统计学意义(P<0.05),12周时无统计学意义(P>0.05);与对照组2对比各时间点都有统计学意义(P<0.01)。与对照组2对比各周期都有统计学意义(P<0.01)。结论:NJF在膝关节功能障碍康复的短、中、长周期中,对关节活动度的改善、疼痛的缓解和功能活动能力的提高起到了促进作用。
Objective:To Study the effects of neuromuscular joint facilitation(NJF) on the knee joint dysfunction.Methods:45 non-athletes patients with knee joint dysfunction in single knee were divided randomly into experimental group,the control group1 and group2(15 cases in each group),all were performed routine therapy.The experimental group was performed NJF.The control group1 was performed the mobilization and the proprioceptive neuromuscular facilitation(PNF).The control group2 was performed the mobilization.All were assessed with AROM / PROM,visual analogue scale(VAS) and Lysholm knee score in the 4th,8th and 12th week respectively.Results:In experimental group,comparison among adjacent time points assessment on VAS had statistical significance(P<0.01).Except comparison between 8th and 12th week,AROM / PROM and Lysholm in other adjacent time points had statistical significance(P <0.05 on AROM/PROM,P<0.01 on Lysholm).Component comparison:①Between experimental group and control group1,AROM in 4th and 8th week and PROM in 4th week had statistical significance(P<0.05).AROM / PROM of experimental group and control group1 in 4th and 8th week had significantly different compared with group2(P<0.05).②VAS of experimental group in 8th and 12th week compared with other groups had significantly different(P<0.05 in 8th week,P<0.01 in 12th week).③Lysholm of experimental group had significantly difference,in the 4th and 8th week compared with the control group1 and in all time point compared with the control group2(P<0.05 in group1,P<0.01in group2).Implication: In each treatment cycle,the NJF promoted ROM,pain relief and functional motion.
Objective:To Study the effects of neuromuscular joint facilitation(NJF) on the knee joint dysfunction.Methods:45 non-athletes patients with knee joint dysfunction in single knee were divided randomly into experimental group,the control group1 and group2(15 cases in each group),all were performed routine therapy.The experimental group was performed NJF.The control group1 was performed the mobilization and the proprioceptive neuromuscular facilitation(PNF).The control group2 was performed the mobilization.All were assessed with AROM / PROM,visual analogue scale(VAS) and Lysholm knee score in the 4th,8th and 12th week respectively.Results:In experimental group,comparison among adjacent time points assessment on VAS had statistical significance(P<0.01).Except comparison between 8th and 12th week,AROM / PROM and Lysholm in other adjacent time points had statistical significance(P <0.05 on AROM/PROM,P<0.01 on Lysholm).Component comparison:①Between experimental group and control group1,AROM in 4th and 8th week and PROM in 4th week had statistical significance(P<0.05).AROM / PROM of experimental group and control group1 in 4th and 8th week had significantly different compared with group2(P<0.05).②VAS of experimental group in 8th and 12th week compared with other groups had significantly different(P<0.05 in 8th week,P<0.01 in 12th week).③Lysholm of experimental group had significantly difference,in the 4th and 8th week compared with the control group1 and in all time point compared with the control group2(P<0.05 in group1,P<0.01in group2).Implication: In each treatment cycle,the NJF promoted ROM,pain relief and functional motion.
引文
[1]霍明,陈立嘉.神经肌肉关节促进法[M].第1版.北京:人民军医出版社,2012.
[2]吴洪,冉春风,等.神经肌肉关节促进法对膝关节粘连关节镜松解术后的治疗作用[J].中国康复,2010,25(2):123~125.
[3]霍明,秋山纯和.康复治疗技术-神经肌肉促进法[M].第1版.北京:人民军医出版社,2007.
[4]苏继承.骨伤科康复技术[M].第1版.北京:人民卫生出版社,2008.
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[6]Geoff D.Maitland,Elly Hengeveld,et al.Maitland's Vertebral Manipulation[M].7th ed.Elsevier Limited,2005.
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[8]谭斌,周道,等.膝关节周围骨折内固定术后关节功能障碍原因分析[J].中国伤残医学,2008,16(5):34~35.
[9]缪芸,倪朝民,等.膝部损伤后膝关节功能障碍患者股四头肌的表面肌电信号研究[J].中国康复理论与实践,2009,15(11):1065~1067.
[10]李涛.前交叉韧带与膝关节本体感觉关系的研究进展[J].中国康复理论与实践,2012,18(8):734~739.
[11]吴术红,刘毅,等.前交叉韧带重建后本体感觉的改变及康复[J].中国组织工程研究与临床康复,2009,13(50):9962~9965.
[12]蒋拥军,李克军,等.平衡促进训练对膝关节前交叉韧带损伤重建术后患膝本体感觉的影响[J].中国康复医学杂志,2011,26(3):251~255.
[13]师东良,李靖龙,等.前交叉韧带损伤后的中枢神经系统功能重塑[J].中国康复医学杂志,2012,27(1):59~62.
[14]万里,王国新.关节松动术在膝关节功能障碍中的应用[J].中国康复医学杂志,2003,18(9):558.
[15]尹汉逵,武建福,等.松动术结合肌力训练对术后膝关节功能障碍的影响[J].现代中西医结合杂志,2008,17(27):4290~4291.
[16]涂小华,宋奇志,等.关节松动术在膝关节功能障碍的应用[J].现代医药卫生,2006,20:3099~3100.
[17]毛慧燕,车世钦.肩胛骨松解法治疗慢性肩周炎的康复疗效[J].中国康复,2006,21(5):321~322.
[18]车世钦,厉翠珍,等.PNF技术在肘关节骨折术后功能障碍中的应用[J].按摩与康复医学,2011,2(21)14~16.
[19]车世钦.结合PNF的关节松动术(MWP)技术治疗肘关节功能障碍初探[J].中国伤残医学,2012,10:9~11.
[20]王俊,张志杰,等.水中PNF技术对膝关节损伤后功能障碍的治疗作用[J].中国康复,2009,24(3):187~189.
[21]武建福,张雄伟,等.松动术结合PNF疗法对膝关节功能障碍的影响[J].浙江实用医学,2008,13(6):419~420.
[2]吴洪,冉春风,等.神经肌肉关节促进法对膝关节粘连关节镜松解术后的治疗作用[J].中国康复,2010,25(2):123~125.
[3]霍明,秋山纯和.康复治疗技术-神经肌肉促进法[M].第1版.北京:人民军医出版社,2007.
[4]苏继承.骨伤科康复技术[M].第1版.北京:人民卫生出版社,2008.
[5]纪树荣.运动疗法技术学[M].第1版.北京:华夏出版社,2004.91~93.
[6]Geoff D.Maitland,Elly Hengeveld,et al.Maitland's Vertebral Manipulation[M].7th ed.Elsevier Limited,2005.
[7]范振华.骨科康复医学[M].第1版.上海:上海医科大学出版社,1999.6~21.
[8]谭斌,周道,等.膝关节周围骨折内固定术后关节功能障碍原因分析[J].中国伤残医学,2008,16(5):34~35.
[9]缪芸,倪朝民,等.膝部损伤后膝关节功能障碍患者股四头肌的表面肌电信号研究[J].中国康复理论与实践,2009,15(11):1065~1067.
[10]李涛.前交叉韧带与膝关节本体感觉关系的研究进展[J].中国康复理论与实践,2012,18(8):734~739.
[11]吴术红,刘毅,等.前交叉韧带重建后本体感觉的改变及康复[J].中国组织工程研究与临床康复,2009,13(50):9962~9965.
[12]蒋拥军,李克军,等.平衡促进训练对膝关节前交叉韧带损伤重建术后患膝本体感觉的影响[J].中国康复医学杂志,2011,26(3):251~255.
[13]师东良,李靖龙,等.前交叉韧带损伤后的中枢神经系统功能重塑[J].中国康复医学杂志,2012,27(1):59~62.
[14]万里,王国新.关节松动术在膝关节功能障碍中的应用[J].中国康复医学杂志,2003,18(9):558.
[15]尹汉逵,武建福,等.松动术结合肌力训练对术后膝关节功能障碍的影响[J].现代中西医结合杂志,2008,17(27):4290~4291.
[16]涂小华,宋奇志,等.关节松动术在膝关节功能障碍的应用[J].现代医药卫生,2006,20:3099~3100.
[17]毛慧燕,车世钦.肩胛骨松解法治疗慢性肩周炎的康复疗效[J].中国康复,2006,21(5):321~322.
[18]车世钦,厉翠珍,等.PNF技术在肘关节骨折术后功能障碍中的应用[J].按摩与康复医学,2011,2(21)14~16.
[19]车世钦.结合PNF的关节松动术(MWP)技术治疗肘关节功能障碍初探[J].中国伤残医学,2012,10:9~11.
[20]王俊,张志杰,等.水中PNF技术对膝关节损伤后功能障碍的治疗作用[J].中国康复,2009,24(3):187~189.
[21]武建福,张雄伟,等.松动术结合PNF疗法对膝关节功能障碍的影响[J].浙江实用医学,2008,13(6):419~420.