膝关节均衡手法对全膝关节置换术后患者康复的影响
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摘要
目的观察膝关节均衡手法对人工全膝关节置换术(TKA)术后患者康复的影响。方法将60例TKA术后患者按随机数字表法分为2组。对照组30例予常规康复治疗;康复组30例在常规康复治疗基础上加用均衡手法治疗。2组均治疗2周,采用美国特种外科医院膝关节评分(HSS)观察2组术后、术后2周疼痛、功能、活动度、肌力、屈膝畸形及稳定性评分,应用三维步态分析仪检测步长、步速和步频步态参数。结果术后2周各项HSS评分均升高(P<0.05),且康复组均高于对照组(P<0.05)。术后2周2组步态参数均升高(P<0.05),且康复组高于对照组(P<0.05)。结论膝关节均衡手法可明显改善TKA术后患者关节活动度,促进功能恢复。
Objective To observe the effects of knee joint balance manipulation on the rehabilitation of patients after total knee arthroplasty(TKA). Methods 60 TKA patients were divided into two groups according to random number table method. 30 cases in control group were treated by routine rehabilitation treatment. 30 cases in rehabilitation group were treated by balanced manipulation on the basis of routine rehabilitation treatment. Both groups were treated for 2 weeks. The knee joint score of American Special Surgery Hospital(HSS) was used to observe the pain, function, range of motion, muscle strength, knee flexion deformity and stability scores of two groups after operation and 2 weeks after operation. Three-dimensional gait analyzer was used to analyze the gait parameters of step length, step speed and step frequency. Results The HSS score of the two groups were increased at 2 weeks after operation(P<0.05), and the rehabilitation group was higher than the control group(P<0.05). The gait parameters of the two groups were increased at 2 weeks after operation(P<0.05), and the rehabilitation group was higher than the control group(P<0.05). Conclusion Knee joint balance manipulation can significantly improve the range of motion of patients after TKA and promote functional recovery.
Objective To observe the effects of knee joint balance manipulation on the rehabilitation of patients after total knee arthroplasty(TKA). Methods 60 TKA patients were divided into two groups according to random number table method. 30 cases in control group were treated by routine rehabilitation treatment. 30 cases in rehabilitation group were treated by balanced manipulation on the basis of routine rehabilitation treatment. Both groups were treated for 2 weeks. The knee joint score of American Special Surgery Hospital(HSS) was used to observe the pain, function, range of motion, muscle strength, knee flexion deformity and stability scores of two groups after operation and 2 weeks after operation. Three-dimensional gait analyzer was used to analyze the gait parameters of step length, step speed and step frequency. Results The HSS score of the two groups were increased at 2 weeks after operation(P<0.05), and the rehabilitation group was higher than the control group(P<0.05). The gait parameters of the two groups were increased at 2 weeks after operation(P<0.05), and the rehabilitation group was higher than the control group(P<0.05). Conclusion Knee joint balance manipulation can significantly improve the range of motion of patients after TKA and promote functional recovery.
引文
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[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] 唐侠.早期功能锻炼对膝关节置换术后功能恢复的影响[J].中华全科医学,2014,12(8):1331-1332,1343.
[15] 岳雨珊,俞君,张文毅,等.三维步态分析的研究进展[J].中华生物医学工程杂志,2011,17(4):372-376.
[16] 洪欣,景明,龚云秀,等.骨盆矫正骨膜压揉治疗膝骨性关节炎57例临床疗效观察[J].云南中医中药杂志,2013,34(2):13-15.
[17] 翟伟韬,戴号,王凌椿.中医手法在僵硬膝人工全膝关节置换术术后关节活动度恢复中的应用[J].河北中医,2012,34(12):1835-1837.
[18] 丁元元,王志相.膝周均衡手法治疗膝骨性关节炎[J].中国民族民间医药,2011,20(16):77-78.
[19] Adams JD,Garcia C.Palliative care among Chumash people[J].Evid Based Complement Alternat Med,2005,2(2):143-147.
[20] 张宏,徐俊,严隽陶,等.推拿对骨骼肌减少症患者伸膝速度和肌电的干预作用[J].上海中医药大学学报,2005,19(2):40-41.
[21] Berth A,Urbach D,Awiszus F.Improvement of voluntary quadriceps muscle activation after total knee arthroplasty[J].Arch Phys Med Rehabil,2002,83(10):1432-1436.
[2] Mathiessen A,Conaghan PG.Conaghan.Synovitis in osteoarthritis:current understanding with therapeutic implications[J].Arthritis Res Ther,2017,19(1):18.
[3] 刘四清,赵汉平.全膝关节置换术后康复效果及患者满意度的比较研究[J].实用医药杂志,2016,33(3):241-243.
[4] 白伟杰,伍中庆,邓宾,等.人工全膝关节置换术围手术期行针灸、推拿结合康复治疗临床观察[J].按摩与康复医学,2014,5(3):29-31.
[5] 宋伟,秦四清,姚建锋,等.严重膝骨性关节炎人工全膝关节置换术后生存质量评价[J].中华骨与关节外科杂志,2010,3(5):379-383.
[6] 罗伦,袁菊莲,李攀,等.中医推拿在膝关节置换术后康复治疗中的应用[J].中医正骨,2014,26(11):50-51.
[7] 付婷婷.郑氏推拿在膝关节置换术后康复治疗中的应用效果观察[J].中医临床研究,2018,10(5):78-80.
[8] 中华医学会风湿病学分会.骨关节炎诊断及治疗指南[J].中华风湿病学杂志,2010,14(6):416-419.
[9] 侯军杰,王卫刚,谭国昭.舒筋活血汤联合中医推拿对人工全膝关节置换术后患者康复的影响[J].河北中医,2018,40(6):847-851.
[10] 宋阳春,孙奎,朱俊琛,等.针刀配合肌力平衡手法治疗膝骨关节炎的临床研究[J].中医正骨,2012,24(9):20-23.
[11] Lyman S,Lee YY,Franklin PD,et al.Validation of the KOOS,JR:a short-form knee arthroplasty outcomes survey[J].Clin Orthop Relat Res,2016,474(6):1461-1471.
[12] Egloff C,Hügle T,Valderrabano V.Biomechanics and pathomechanisms of osteoarthritis[J].Swiss Med Wkly,2012,142(14):w13583.
[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] 唐侠.早期功能锻炼对膝关节置换术后功能恢复的影响[J].中华全科医学,2014,12(8):1331-1332,1343.
[15] 岳雨珊,俞君,张文毅,等.三维步态分析的研究进展[J].中华生物医学工程杂志,2011,17(4):372-376.
[16] 洪欣,景明,龚云秀,等.骨盆矫正骨膜压揉治疗膝骨性关节炎57例临床疗效观察[J].云南中医中药杂志,2013,34(2):13-15.
[17] 翟伟韬,戴号,王凌椿.中医手法在僵硬膝人工全膝关节置换术术后关节活动度恢复中的应用[J].河北中医,2012,34(12):1835-1837.
[18] 丁元元,王志相.膝周均衡手法治疗膝骨性关节炎[J].中国民族民间医药,2011,20(16):77-78.
[19] Adams JD,Garcia C.Palliative care among Chumash people[J].Evid Based Complement Alternat Med,2005,2(2):143-147.
[20] 张宏,徐俊,严隽陶,等.推拿对骨骼肌减少症患者伸膝速度和肌电的干预作用[J].上海中医药大学学报,2005,19(2):40-41.
[21] Berth A,Urbach D,Awiszus F.Improvement of voluntary quadriceps muscle activation after total knee arthroplasty[J].Arch Phys Med Rehabil,2002,83(10):1432-1436.