【摘要】：背景:研究發(fā)現(xiàn),肌電生物反饋康復(fù)治療對術(shù)后患者的步行能力有明顯改善作用。目的:比較多種康復(fù)方式對老年人工全膝關(guān)節(jié)置換后患者下肢運動功能的影響。方法:采用電腦隨機分配法將153例人工全膝關(guān)節(jié)置換后患者分為常規(guī)基礎(chǔ)康復(fù)組、肌電生物反饋康復(fù)組及聯(lián)合康復(fù)組。入選患者均給予常規(guī)基礎(chǔ)康復(fù)訓(xùn)練,肌電生物反饋康復(fù)組輔以股四頭肌肌電生物反饋康復(fù)治療,聯(lián)合康復(fù)組則在常規(guī)康復(fù)方式基礎(chǔ)上加用肌電生物反饋及減重平板訓(xùn)練。治療8周后,對3組患者下肢運動功能、ADL能力、平衡功能、膝關(guān)節(jié)屈伸活動度、步行能力、膝關(guān)節(jié)功能HSS評分,下肢功能評分(LEFS)進行量化評估;并評估疼痛目測類比評分、靜息和主動運動狀態(tài)下的股四頭肌積分肌電值(sE MG)、踝背伸拮抗肌協(xié)同收縮率、Fugl-Meyer量表(FMA)評分、Barthel指數(shù)(MBI)、Berg平衡量表(BBS)、通用量角器及Holden步行功能分級。結(jié)果與結(jié)論:(1)與治療前、常規(guī)基礎(chǔ)康復(fù)組及肌電生物反饋康復(fù)組比較,聯(lián)合康復(fù)組治療后目測類比評分明顯降低(P0.01);(2)聯(lián)合康復(fù)組中HHS評分及LEFS評分高于常規(guī)基礎(chǔ)康復(fù)訓(xùn)練組及肌電生物反饋康復(fù)組(P0.05);(3)聯(lián)合康復(fù)組sE MG分值、拮抗肌協(xié)同收縮率、下肢FMA評分、MBI評分、膝關(guān)節(jié)屈伸活動度、最大步速、步長及Holden步行功能均優(yōu)于其余2組(P0.05);(4)在選取的多種術(shù)后康復(fù)方式中,聯(lián)合康復(fù)療法能顯著提高老年人工全膝關(guān)節(jié)置換后患者的下肢運動功能,增加下肢肌力,提高術(shù)后的康復(fù)療效。
[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.
【作者單位】： 解放軍蘭州軍區(qū)總醫(yī)院全軍骨科中心關(guān)節(jié)外科;解放軍蘭州軍區(qū)總醫(yī)院體檢中心;
【基金】：國家自然科學(xué)基金資助項目(81371513) 甘肅省青年科技基金(1606RJYA300) 甘肅省自然科學(xué)基金(1606RJZA208) 甘肅省科技支撐計劃(S04671)~~
【分類號】：R687.4
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本文編號：2138304