多种康复方式对老年人工全膝关节置换后下肢运动功能的影响

发布时间：2018-07-22 19:18

【摘要】：背景:研究发现,肌电生物反馈康复治疗对术后患者的步行能力有明显改善作用。目的:比较多种康复方式对老年人工全膝关节置换后患者下肢运动功能的影响。方法:采用电脑随机分配法将153例人工全膝关节置换后患者分为常规基础康复组、肌电生物反馈康复组及联合康复组。入选患者均给予常规基础康复训练,肌电生物反馈康复组辅以股四头肌肌电生物反馈康复治疗,联合康复组则在常规康复方式基础上加用肌电生物反馈及减重平板训练。治疗8周后,对3组患者下肢运动功能、ADL能力、平衡功能、膝关节屈伸活动度、步行能力、膝关节功能HSS评分,下肢功能评分(LEFS)进行量化评估;并评估疼痛目测类比评分、静息和主动运动状态下的股四头肌积分肌电值(sE MG)、踝背伸拮抗肌协同收缩率、Fugl-Meyer量表(FMA)评分、Barthel指数(MBI)、Berg平衡量表(BBS)、通用量角器及Holden步行功能分级。结果与结论:(1)与治疗前、常规基础康复组及肌电生物反馈康复组比较,联合康复组治疗后目测类比评分明显降低(P0.01);(2)联合康复组中HHS评分及LEFS评分高于常规基础康复训练组及肌电生物反馈康复组(P0.05);(3)联合康复组sE MG分值、拮抗肌协同收缩率、下肢FMA评分、MBI评分、膝关节屈伸活动度、最大步速、步长及Holden步行功能均优于其余2组(P0.05);(4)在选取的多种术后康复方式中,联合康复疗法能显著提高老年人工全膝关节置换后患者的下肢运动功能,增加下肢肌力,提高术后的康复疗效。
[Abstract]:Background: myoelectric biofeedback rehabilitation has a significant effect on walking ability of postoperative patients. Objective: to compare the effects of different rehabilitation methods on lower limb motor function in elderly patients after total knee arthroplasty. Methods: 153 patients after total knee arthroplasty were randomly divided into three groups: routine basic rehabilitation group, myoelectric biofeedback rehabilitation group and combined rehabilitation group. All the patients were given routine basic rehabilitation training, myoelectric biofeedback rehabilitation group was supplemented with quadriceps myoelectric biofeedback rehabilitation treatment, and combined rehabilitation group was treated with myoelectric biofeedback and weight loss plate training on the basis of routine rehabilitation. After 8 weeks of treatment, ADL, balance function, flexion and extension of knee joint, walking ability, HSS score of knee joint function, lower limb function score (LEFS) were quantitatively evaluated in three groups, and visual analogue score of pain was evaluated. The integral myoelectric value of quadriceps femoris (SEMG), the Fugl-Meyer scale (FMA) score, the Barthel Index (MBI) Berg balance scale (BBS), the universal protractor and Holden's walking function were measured. Results and conclusion: (1) compared with the routine basic rehabilitation group and the myoelectric biofeedback rehabilitation group before treatment, The visual analogue score (P0.01); (2) in the combined rehabilitation group was significantly lower than that in the conventional basic rehabilitation group and the myoelectric biofeedback rehabilitation group (P0.05); (3), and the synergistic contraction rate of antagonistic muscles was higher than that in the combined rehabilitation group. Lower limb); (score, knee flexion and extension activity, maximum step speed, step length and Holden's walking function were superior to those of the other two groups (P0.05); (4). The combined rehabilitation therapy can significantly improve the lower limb motor function, increase the lower limb muscle strength and improve the postoperative rehabilitation effect of the elderly patients after total knee arthroplasty.
【作者单位】： 解放军兰州军区总医院全军骨科中心关节外科;解放军兰州军区总医院体检中心;
【基金】：国家自然科学基金资助项目(81371513) 甘肃省青年科技基金(1606RJYA300) 甘肃省自然科学基金(1606RJZA208) 甘肃省科技支撑计划(S04671)~~
【分类号】：R687.4
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本文编号：2138304