摘要
目的本研究的目的是探讨循环渐进式康复策略对前交叉韧带(ACL)重建术后股四头肌力量和膝关节功能恢复的影响。方法98例曾行自体腘绳肌腱重建ACL的患者,按患者接受的康复策略分为试验组(n=52)和对照组(n=46)。试验组包括男性38例,女性14例,平均年龄(28.64±7.1)岁;对照组包括男性35例,女性11例,平均年龄(29.42±6.9)岁。对照组遵循常规的术后康复策略,试验组接受本课题组制订的循环渐进式个体化康复策略。在术后第4周、第12周和第24周测量股四头肌最大自主等长收缩。使用单腿跳跃距离测试、国际膝关节文件委员会2000主观膝关节表和Lysholm膝关节功能评分评估术后24周的膝关节功能。结果与对照组相比,试验组在术后第12周的股四头肌MVIC更大,其中试验组为(2.53±0.48)Nm/kg,对照组为(2.07±0.38)Nm/kg(P<0.001)。在术后第24周,与对照组相比,试验组的股四头肌强度更大,其中试验组为(2.96±0.51)Nm/kg,对照组为(2.41±0.49)Nm/kg(P<0.001)。术后24周时,试验组OLHDT为(89.91±9.51)分,对照组为(85.32±10.12)分;试验组IKDC评分为(84.91±9.43)分,对照组为(79.45±8.86)分;试验组Lysholm评分为(89.35±8.47)分,对照组为(76.97±7.63)分,以上各评价指标中试验组均显著优于对照组(所有P<0.05)。在膝关节功能恢复优良率方面,试验组优良率显著高于(92.31%,48/52)对照组(76.09%,35/46,P=0.026)。结论本课题组制订的循环渐进式个体化康复策略有益于股四头肌力量和膝关节功能恢复。在ACLR康复治疗中,尤其是在康复治疗的早期阶段,本康复策略经证实为一种安全且有效的康复训练方式。
Objective The aim of this study was to investigate the effect of a cyclic progressive re-habilitation strategy on quadriceps strength and knee function recovery after anterior cruciate ligament(ACL)reconstruction.Methods Ninety-eight patients who had undergone ACL reconstruction with autolo-gous hamstring tendons were divided into test group(n=52)and control group(n=46)according to the reha-bilitation strategy received by the patients.The control group followed the conventional postoperative reha-bilitation strategy,and the experimental group received the cyclic progressive individualized rehabilitation strategy developed by our group.Maximal voluntary isometric contraction(MVIC)of the quadriceps femo-ris muscle was measured at 4,12,and 24 weeks after surgery.The One-Leg Hop for Distance Test(OLH-DT),International Knee Documentation Committee 2000 Subjective Knee Form(IKDC),and Lysholm knee function scores were used to assess knee function at 24 weeks.Results The MVIC of the quadriceps femo-ris muscle at 12 weeks after surgery was significantly higher in the test group than in the control group(P<0.001).At 24 weeks after surgery,the strength of the quadriceps femoris muscle in the test group was signifi-cantly greater than that in the control group(P<0.001).The OLHDT,IKDC score and Lysholm score at 24 hours after surgery in the test group were significantly higher than those in the control group(all P<0.05).In terms of the excellent and good rate of knee joint function recovery,the excellent and good rate was 92.31%(48/52)in the test group and 76.09%(35/46)in the control group,and the excellent and good rate in the test group was significantly higher than that in the control group(P=0.026).Conclusions The cyclic progres-sive individualized rehabilitation strategy developed by our group is beneficial to the recovery of quadriceps strength and knee joint function.This rehabilitation strategy has been proven to be a safe and effective reha-bilitation modality in ACLR rehabilitation,especially in the early stages of rehabilitation.
作者
耿倩
鹿青
李莎
臧雅静
顾聚源
GengQian;LuQing;LiSha;Zang-Yajing;Gu Juyuan(The 2ndjoint surgery department,the Third Hospital of Hebei Medical University,Shijia-zhuang 050051,China)
出处
《中华老年骨科与康复电子杂志》
2023年第2期101-107,共7页
Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)
基金
河北省医学科学研究课题(20190674)。
关键词
前交叉韧带
前交叉韧带重建术
股四头肌力量
康复策略
术后护理
Anterior cruciate ligament
Anterior cruciate ligament reconstruction
Quadriceps strength
Rehabilitation strategy
Postoperative care
