膝关节置换后早期强调步态训练对患者功能恢复的影响

发布时间：2018-03-30 08:25

本文选题：关节成形术　切入点：置换　出处：《中国组织工程研究》2017年27期

【摘要】：背景:膝关节置换可以解决患者的膝关节畸形、疼痛、功能受限等,从而提高患者的生活质量,而置换后早期康复介入和康复治疗的着重点是患者功能恢复绝对性因素。目的:观察早期步态训练对膝关节置换后患者康复的临床疗效。方法:选取86例运动医学科专组所做的单膝膝关节表面置换后患者,将其随机分为训练+常规治疗组和常规治疗组,每组43例患者。训练+常规治疗组于术前进行康复指导,关节置换后离床即进行步态训练,使患者按正确的步行模式行走。常规治疗组只对膝关节置换康复原则中的基础康复进行训练,而对步态训练没有硬性要求。分别于置换后2,4,8周和6个月进行评价,对两组患者在治疗前后膝前疼痛、膝关节功能(HSS)进行评估,比较两组治疗前后的临床疗效。结果与结论:①膝关节置换后4周,8周及6个月时,训练+常规治疗组与常规治疗组相比膝关节活动角度明显增大(P0.05);②置换后8周及6个月,训练+常规治疗组与常规治疗组相比目测类比评分明显降低(P0.05);③置换后2周,训练+常规治疗组与常规治疗组相比HSS评分明显升高(P0.05);置换后8周,训练+常规治疗组与常规治疗组相比HSS评分升高,但差异并不显著(P0.05);置换后6个月,训练+常规治疗组HSS评分显著高于常规治疗组;④结果说明,早期步态训练较常规治疗,能够在一定程度上改善膝关节的活动角度、膝关节疼痛及整体功能,并明显优于常规治疗组。证实早期步态训练对膝关节置换后患者康复可以恢复步行能力,提高患者综合功能,快速、持续消除疼痛与活动受限,具有显著的疗效。
[Abstract]:Background: knee arthroplasty can solve the patients with knee joint deformity, pain, limited function, so as to improve the quality of life of patients, and the focus of postoperative early rehabilitation intervention and rehabilitation therapy in patients with functional recovery of absolute factors. Objective: To observe the clinical effect of early gait training on the rehabilitation of patients after total knee arthroplasty. Patient: select 86 cases of sports medicine, specifically done by a group of single knee knee arthroplasty, were randomly divided into training and routine treatment group and routine treatment group, 43 patients in each group. The training and routine treatment group in the preoperative rehabilitation guidance, joint replacement from the bed of gait training, the in accordance with the right of walking walking. The conventional treatment group was trained only on the basis of the principle of rehabilitation in the rehabilitation of knee joint replacement, but not for gait training mandatory requirements. In 2,4,8 weeks and 6 months after replacement evaluation Of the two groups, before and after treatment in patients with anterior knee pain, knee joint function (HSS) to assess clinical curative effect before and after treatment between the two groups. Results and conclusion: 4 weeks after total knee arthroplasty, 8 weeks and 6 months of training, and routine treatment group and routine treatment group compared with the knee angle increased significantly (P0.05); replacement after 8 weeks and 6 months of training and routine treatment group and routine treatment group compared with the visual analogue score was significantly lower (P0.05); the 2 weeks after replacement, training and routine treatment group and routine treatment group compared with the HSS score increased significantly (P0.05); the change after 8 weeks training, and routine treatment group and routine treatment group compared with the HSS score increased, but the difference was not significant (P0.05); 6 months after replacement, training + conventional treatment group HSS score was significantly higher than normal group; the results showed that the gait training compared with conventional treatment, can improve the knee joint to a certain extent, the activities of angle Knee pain and overall function were significantly better than those in the conventional treatment group. It is confirmed that early gait training can restore walking ability after knee replacement, improve the comprehensive function of patients, and relieve pain and activity limitation quickly and continuously, which has a significant effect.

【作者单位】：大连市中心医院运动医学科;
【分类号】：R473.6

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