系统康复训练对运动爱好者前交叉韧带重建术后运动功能恢复的临床疗效
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摘要
目的探讨系统综合康复训练对运动损伤前交叉韧带重建术后功能恢复的临床意义。方法选取2015年1月—2016年10月住院患者中符合纳入排除标准的在关节镜下行膝关节自体肌腱重建手术治疗的患者。术后根据患者个体情况、手术情况、运动爱好等因素指导患者进行分4个阶段、共16周的系统康复训练。术前及术后3、6、12个月分别测量视觉模拟疼痛评分(Visual Analogue Scale,VAS)、关节活动度、膝关节周径、10 m步行时间。同时对膝关节功能和稳定性采用Lysholm评分、Holden步行功能分级、国际膝关节文献委员会(International Knee Documentation Committee,IKDC)膝关节评估表评分及膝关节松弛度KT-1000值进行评定。术后12个月比较患者患侧与健侧的膝关节,评估患者恢复水平;评定术后12个月时的患者满意度。结果全部患者获得12个月随访。术后12个月时患者的VAS疼痛评分、关节活动度、膝关节周径、10 m步行时间、Lysholm评分、Holden评分、IKDC评分及KT-1000值均优于术前(P<0.05),无关节感染等严重并发症发生,且与健侧关节功能水平对比差异无统计学意义(P>0.05)。结论系统综合康复训练能帮助前交叉韧带重建术后患者恢复良好的膝关节功能水平。
Objective To explore the clinical significance of systemic rehabilitation training on knee functional recovery after anterior cruciate ligament(ACL) reconstruction. Methods Patients who underwent arthroscopic knee ACL reconstruction and met the inclusion criteria were included from January 2015 to October 2016. A 4-phase, 16-week systemic rehabilitation training was given individually according to surgical conditions, sports and other factors. Visual Analogue Scale(VAS), knee range of motion(ROM), knee circumference, and 10-meter walking time were measured before surgery, and 3, 6, and 12 months after surgery. At the same time, the function and stability of the knee joint were graded by Lysholm score, Holden walking score, International Knee Documentation Committee(IKDC) score, and KT-1000 test. The postoperative one-year scores were compared with the other side, and the patient satisfaction was evaluated one year after surgery. Results All patients were followed up for at least one year. The VAS pain score, ROM, knee circumference, 10-meter walking time, Lysholm score, Holden score, IKDC score, and KT-1000 of all patients were significantly better than their preoperative levels(P<0.05), and there was no significant difference in joint function from the contralateral side(P>0.05). No serious complications such as infection occurred. Conclusion Systemic rehabilitation exercises can help patients with well-restored knee joint function after ACL reconstruction.
Objective To explore the clinical significance of systemic rehabilitation training on knee functional recovery after anterior cruciate ligament(ACL) reconstruction. Methods Patients who underwent arthroscopic knee ACL reconstruction and met the inclusion criteria were included from January 2015 to October 2016. A 4-phase, 16-week systemic rehabilitation training was given individually according to surgical conditions, sports and other factors. Visual Analogue Scale(VAS), knee range of motion(ROM), knee circumference, and 10-meter walking time were measured before surgery, and 3, 6, and 12 months after surgery. At the same time, the function and stability of the knee joint were graded by Lysholm score, Holden walking score, International Knee Documentation Committee(IKDC) score, and KT-1000 test. The postoperative one-year scores were compared with the other side, and the patient satisfaction was evaluated one year after surgery. Results All patients were followed up for at least one year. The VAS pain score, ROM, knee circumference, 10-meter walking time, Lysholm score, Holden score, IKDC score, and KT-1000 of all patients were significantly better than their preoperative levels(P<0.05), and there was no significant difference in joint function from the contralateral side(P>0.05). No serious complications such as infection occurred. Conclusion Systemic rehabilitation exercises can help patients with well-restored knee joint function after ACL reconstruction.
引文
1许磊,刘宁.系统康复训练对青年人前交叉韧带重建术后运动功能恢复的意义.哈尔滨医科大学学报,2013,47(3):265-268.
2章朝晖,周洪清,夏雪.膝关节前交叉韧带损伤重建术后系统康复锻炼的效果观察.世界最新医学信息文摘,2017,17(58):11-13.
3李棋,唐新,杨天府,等.关节镜下LARS人工韧带重建急性期前交叉韧带损伤的临床疗效观察.中国骨伤,2010,23(12):952-954.
4任丽,叶霞,李伶俐,等.关节镜下前交叉韧带重建术后早期康复疗效观察.华西医学,2012,27(5):758-759.
5梁翼,张世明,胡勇,等.关节镜下膝前交叉韧带重建术后中期中西医结合临床康复研究.中国中医骨伤科杂志,2010,18(12):30-32.
6唐兆鹏,李玉吉,李盛华,等.中西医结合康复疗法对膝前交叉韧带保残重建术后本体感觉恢复的影响.西部中医药,2017,30(4):105-107.
7顾莉华,徐玉萍,王蓓琳,等.膝关节镜下前交叉韧带重建术后的康复治疗.上海中医药杂志,2012,46(11):61-63.
8韩国一,李飞.快速康复方案在前交叉韧带损伤重建术后军人中的应用.泰山医学院学报,2017,38(6):631-633.
9陈柯,张杰敏,张馨梅,等.阶段性系统康复锻炼在膝关节前交叉韧带损伤重建术后的应用效果.西部医学,2016,28(4):560-563.
10桑学涵,李小磊,胡瀚生,等.开链与闭链运动对前交叉韧带重建术后的康复疗效对比.中国康复,2017,32(1):61-62.
11马敏超,蒋垚.KT1000/KT2000关节测量仪对前交叉韧带损伤诊断及重建术后移植物稳定性的评估价值.中国组织工程研究与临床康复,2007,11(40):8123-8126.
12曾春,蔡道章,王昆,等.关节镜下前交叉韧带重建术后的康复干预.中国临床康复,2005,9(14):1-3.
13葛杰,周谋望,敖英芳,等.关节镜下膝前交叉韧带重建术后的康复.中国康复医学杂志,2003,18(12):743-746.
14Aljaberi M,曾炳芳,赵金忠,等.前交叉韧带重建术中隧道定位对移植物等距特性影响的研究.中华创伤骨科杂志,2006,8(7):663-667.
15闵重函,周瑛,荆琳,等.手法加中药熏蒸对前交叉韧带断裂重建术后膝关节功能康复的病例对照研究.中国骨伤,2016,29(5):397-403.
16唐洪渊.专业运动康复在前交叉韧带重建术后的应用效果.中国医药导报,2016,13(12):77-80.
17李品,陈红云,孔舒娅,等.医护一体化康复锻炼对前交叉韧带重建术后Lysholm评分的影响.中国医学创新,2016,13(24):139-141.
18Nae J,Creaby MW,Nilsson G,et al.Measurement properties of a test battery to assess postural orientation during functional tasks in patients undergoing anterior cruciate ligament injury rehabilitation.J Orthop Sports Phys Ther,2017,47(11):863-873.
2章朝晖,周洪清,夏雪.膝关节前交叉韧带损伤重建术后系统康复锻炼的效果观察.世界最新医学信息文摘,2017,17(58):11-13.
3李棋,唐新,杨天府,等.关节镜下LARS人工韧带重建急性期前交叉韧带损伤的临床疗效观察.中国骨伤,2010,23(12):952-954.
4任丽,叶霞,李伶俐,等.关节镜下前交叉韧带重建术后早期康复疗效观察.华西医学,2012,27(5):758-759.
5梁翼,张世明,胡勇,等.关节镜下膝前交叉韧带重建术后中期中西医结合临床康复研究.中国中医骨伤科杂志,2010,18(12):30-32.
6唐兆鹏,李玉吉,李盛华,等.中西医结合康复疗法对膝前交叉韧带保残重建术后本体感觉恢复的影响.西部中医药,2017,30(4):105-107.
7顾莉华,徐玉萍,王蓓琳,等.膝关节镜下前交叉韧带重建术后的康复治疗.上海中医药杂志,2012,46(11):61-63.
8韩国一,李飞.快速康复方案在前交叉韧带损伤重建术后军人中的应用.泰山医学院学报,2017,38(6):631-633.
9陈柯,张杰敏,张馨梅,等.阶段性系统康复锻炼在膝关节前交叉韧带损伤重建术后的应用效果.西部医学,2016,28(4):560-563.
10桑学涵,李小磊,胡瀚生,等.开链与闭链运动对前交叉韧带重建术后的康复疗效对比.中国康复,2017,32(1):61-62.
11马敏超,蒋垚.KT1000/KT2000关节测量仪对前交叉韧带损伤诊断及重建术后移植物稳定性的评估价值.中国组织工程研究与临床康复,2007,11(40):8123-8126.
12曾春,蔡道章,王昆,等.关节镜下前交叉韧带重建术后的康复干预.中国临床康复,2005,9(14):1-3.
13葛杰,周谋望,敖英芳,等.关节镜下膝前交叉韧带重建术后的康复.中国康复医学杂志,2003,18(12):743-746.
14Aljaberi M,曾炳芳,赵金忠,等.前交叉韧带重建术中隧道定位对移植物等距特性影响的研究.中华创伤骨科杂志,2006,8(7):663-667.
15闵重函,周瑛,荆琳,等.手法加中药熏蒸对前交叉韧带断裂重建术后膝关节功能康复的病例对照研究.中国骨伤,2016,29(5):397-403.
16唐洪渊.专业运动康复在前交叉韧带重建术后的应用效果.中国医药导报,2016,13(12):77-80.
17李品,陈红云,孔舒娅,等.医护一体化康复锻炼对前交叉韧带重建术后Lysholm评分的影响.中国医学创新,2016,13(24):139-141.
18Nae J,Creaby MW,Nilsson G,et al.Measurement properties of a test battery to assess postural orientation during functional tasks in patients undergoing anterior cruciate ligament injury rehabilitation.J Orthop Sports Phys Ther,2017,47(11):863-873.