膝關(guān)節(jié)位置重現(xiàn)對前交叉韌帶重建患者本體感覺的研究
發(fā)布時間：2018-08-27 14:57
【摘要】：研究背景:隨著全民健身運(yùn)動意識的提高,運(yùn)動損傷導(dǎo)致前交叉韌帶(Anterior Cruciate Ligament,ACL)斷裂的發(fā)病率逐年增加,而且常發(fā)生于中青年。ACL重建(ACL reconstruction,ACLR)是ACL斷裂的現(xiàn)行標(biāo)準(zhǔn)治療手段。ACLR后ACL功能的恢復(fù),不僅依賴于解剖結(jié)構(gòu)的恢復(fù),其本體感覺功能的恢復(fù)同樣重要。膝關(guān)節(jié)位置重現(xiàn)作為本體感覺訓(xùn)練和測試的方法之一,已成功運(yùn)用于膝關(guān)節(jié)本體感覺的測試,但運(yùn)用此方法進(jìn)行本體感覺訓(xùn)練的研究并不多。目的:本研究借助可視化數(shù)字軟件及互聯(lián)網(wǎng)通訊,應(yīng)用膝關(guān)節(jié)位置重現(xiàn)訓(xùn)練強(qiáng)化患者本體感覺,觀察其對ACLR后患者的影響,求證膝關(guān)節(jié)位置重現(xiàn)在治療ACLR中的有效性和實(shí)用性,為其臨床應(yīng)用和推廣提供一定的科學(xué)依據(jù)。方法:收集符合納入標(biāo)準(zhǔn)的患者,將其隨機(jī)分為實(shí)驗(yàn)組和對照組,對照組患者行康復(fù)教育、物理治療、自我訓(xùn)練等常規(guī)治療;實(shí)驗(yàn)組患者在常規(guī)治療的基礎(chǔ)上增加可視化數(shù)字軟件下膝關(guān)節(jié)位置重現(xiàn)訓(xùn)練。評估兩組患者術(shù)前、術(shù)后1周、術(shù)后5周膝關(guān)節(jié)位置重現(xiàn)(評估15°、30°、45°)的差異值、下肢周徑萎縮指數(shù)、Berg 量表(Berg Balance Scale,BBS)、Barthel指數(shù)(Barthel lndex,BI)、視覺模擬評分表(Visual Analog Scale,VAS)等臨床指標(biāo)。采用20.0版SPSS軟件行統(tǒng)計(jì)分析,評估療效,P值0.05具統(tǒng)計(jì)學(xué)意義。結(jié)果:本研究最終納入符合標(biāo)準(zhǔn)的患者61例,其中實(shí)驗(yàn)組31例,對照組30例。1.膝關(guān)節(jié)本體感覺功能1.1與術(shù)前相比,術(shù)后5周兩組患者患側(cè)膝關(guān)節(jié)位置重現(xiàn)差異與術(shù)前測量值相比有顯著意義(P0.05),且實(shí)驗(yàn)組差異值較對照組小,兩組健側(cè)相比無統(tǒng)計(jì)學(xué)差異(P0.05)。1.2術(shù)后5周兩組相比,實(shí)驗(yàn)組患側(cè)膝關(guān)節(jié)位置重現(xiàn)差異值在30°、45°時有統(tǒng)計(jì)學(xué)差異(P0.05),實(shí)驗(yàn)組患側(cè)15°以及健側(cè)所有目標(biāo)角度無統(tǒng)計(jì)學(xué)差異(P0.05)。2.下肢周徑萎縮指數(shù)2.1與術(shù)前相比,術(shù)后5周兩組患者髕上10cm周徑萎縮指數(shù)(P0.001),髕下10cm周徑萎縮指數(shù)(P0.05)有統(tǒng)計(jì)學(xué)意義,實(shí)驗(yàn)組的萎縮指數(shù)小于對照組。2.2術(shù)后5周,實(shí)驗(yàn)組和對照組髕上10cm、髕下10cm周徑萎縮指數(shù)相比有統(tǒng)計(jì)學(xué)差異(P0.05)。3.Lysholm 評分、VAS、BBS、BI3.1兩組患者術(shù)前與術(shù)后1周、術(shù)后1周與術(shù)后5周的Lysholm評分、VAS、BBS、BI的結(jié)果具有顯著性差異(P0.001),兩組患者術(shù)前和術(shù)后5周VAS、BI結(jié)果有統(tǒng)計(jì)學(xué)意義(P0.05),Lysholm評分及BBS結(jié)果無顯著性差異(P0.05)。3.2兩組患者相比,術(shù)后1周、術(shù)后5周Lysholm評分、VAS、BBS、BI的結(jié)果均無統(tǒng)計(jì)學(xué)意義(P0.05),但術(shù)后5周實(shí)驗(yàn)組Lysholm評分、BBS、BI的結(jié)果較對照組大,VAS的結(jié)果較對照組小。結(jié)論:ACLR后在常規(guī)康復(fù)治療的基礎(chǔ)上,輔以可視化數(shù)字軟件下膝關(guān)節(jié)位置重現(xiàn)訓(xùn)練有利于患者本體感覺的恢復(fù)、預(yù)防肌肉萎縮以及提高膝關(guān)節(jié)整體功能,且此方法簡便易行,適于居家康復(fù),值得臨床推廣和應(yīng)用。
[Abstract]:Background: with the improvement of national fitness awareness, the incidence of anterior cruciate ligament (Anterior Cruciate Ligament,ACL) rupture caused by sports injury is increasing year by year. ACL reconstruction (ACL reconstruction,ACLR), which often occurs in young and middle-aged people, is the current standard treatment for ACL rupture. The recovery of ACL function depends not only on the restoration of anatomical structure, but also on the restoration of proprioceptive function. As one of the methods of proprioceptive training and testing, position reconstruction of knee joint has been successfully applied to the testing of proprioceptive sensation of knee joint. However, there are few researches on proprioceptive training using this method. Objective: to evaluate the effectiveness and practicability of knee joint position reconstruction in the treatment of ACLR by means of visual digital software and Internet communication to strengthen the patient's proprioceptive perception, to observe its effect on the patients after ACLR, and to verify the effectiveness and practicability of knee joint position reconstruction in the treatment of ACLR. It provides a scientific basis for its clinical application and popularization. Methods: the patients who met the inclusion criteria were randomly divided into the experimental group and the control group. The patients in the control group received routine treatment such as rehabilitation education, physical therapy, self-training and so on. On the basis of routine treatment, the patients in the experimental group were trained in knee joint position reconstruction with visual digital software. To evaluate the difference of knee joint position (15 擄~ 30 擄~ 45 擄), lower extremity circumference atrophy index (Berg Balance Scale,BBS), Barthel index (Barthel lndex,BI) and visual analogue scale (Visual Analog Scale,VAS) between the two groups before operation, 1 week after operation and 5 weeks after operation. Statistical analysis was carried out with 20.0 SPSS software, and there was statistical significance in evaluating curative effect (P = 0. 05). Results: 61 patients were included in the study, including 31 patients in the experimental group and 30 patients in the control group. The knee proprioceptive function 1.1 was significantly different between the two groups at 5 weeks after operation (P0.05), and the difference was smaller in the experimental group than that in the control group. There was no significant difference between the two groups in the healthy side (P0.05) .1.2 after 5 weeks after operation, there was statistical difference between the two groups at 30 擄to 45 擄(P0.05), and there was no significant difference in the 15 擄of the affected side and all the target angles of the healthy side in the experimental group (P0.05) .2. The atrophy index of 10cm (P0. 001) and subpatellar 10cm (P0. 05) were significantly lower in the experimental group than in the control group at 5 weeks after operation, and the atrophy index in the experimental group was lower than that in the control group at 5 weeks after operation. There were significant differences between the experimental group and the control group in suprapatellar 10 cm and subpatellar 10cm circumference atrophy index (P0.05). 3. Lysholm score before operation and 1 week after operation. There was significant difference in Lysholm scores between the first week and the fifth week after operation (P0. 001). There was no significant difference between the two groups in VAS,BI scores before and 5 weeks after operation (P0.05) and BBS results (P0.05), 1 week after operation, there was no significant difference between the two groups (P0.05). There was no significant difference in the results of Lysholm scores and Lysholm scores 5 weeks after operation (P0.05), but the results of Lysholm scores in the experimental group were smaller than those in the control group (P0.05). Conclusion on the basis of routine rehabilitation therapy, the reconstruction training of knee joint position under visual digital software is beneficial to the recovery of proprioceptive sensation, the prevention of muscular atrophy and the improvement of the whole function of knee joint, and this method is simple and convenient. It is suitable for family rehabilitation and is worth popularizing and applying in clinic.
【學(xué)位授予單位】：南方醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R687.4
本文編號：2207627
[Abstract]:Background: with the improvement of national fitness awareness, the incidence of anterior cruciate ligament (Anterior Cruciate Ligament,ACL) rupture caused by sports injury is increasing year by year. ACL reconstruction (ACL reconstruction,ACLR), which often occurs in young and middle-aged people, is the current standard treatment for ACL rupture. The recovery of ACL function depends not only on the restoration of anatomical structure, but also on the restoration of proprioceptive function. As one of the methods of proprioceptive training and testing, position reconstruction of knee joint has been successfully applied to the testing of proprioceptive sensation of knee joint. However, there are few researches on proprioceptive training using this method. Objective: to evaluate the effectiveness and practicability of knee joint position reconstruction in the treatment of ACLR by means of visual digital software and Internet communication to strengthen the patient's proprioceptive perception, to observe its effect on the patients after ACLR, and to verify the effectiveness and practicability of knee joint position reconstruction in the treatment of ACLR. It provides a scientific basis for its clinical application and popularization. Methods: the patients who met the inclusion criteria were randomly divided into the experimental group and the control group. The patients in the control group received routine treatment such as rehabilitation education, physical therapy, self-training and so on. On the basis of routine treatment, the patients in the experimental group were trained in knee joint position reconstruction with visual digital software. To evaluate the difference of knee joint position (15 擄~ 30 擄~ 45 擄), lower extremity circumference atrophy index (Berg Balance Scale,BBS), Barthel index (Barthel lndex,BI) and visual analogue scale (Visual Analog Scale,VAS) between the two groups before operation, 1 week after operation and 5 weeks after operation. Statistical analysis was carried out with 20.0 SPSS software, and there was statistical significance in evaluating curative effect (P = 0. 05). Results: 61 patients were included in the study, including 31 patients in the experimental group and 30 patients in the control group. The knee proprioceptive function 1.1 was significantly different between the two groups at 5 weeks after operation (P0.05), and the difference was smaller in the experimental group than that in the control group. There was no significant difference between the two groups in the healthy side (P0.05) .1.2 after 5 weeks after operation, there was statistical difference between the two groups at 30 擄to 45 擄(P0.05), and there was no significant difference in the 15 擄of the affected side and all the target angles of the healthy side in the experimental group (P0.05) .2. The atrophy index of 10cm (P0. 001) and subpatellar 10cm (P0. 05) were significantly lower in the experimental group than in the control group at 5 weeks after operation, and the atrophy index in the experimental group was lower than that in the control group at 5 weeks after operation. There were significant differences between the experimental group and the control group in suprapatellar 10 cm and subpatellar 10cm circumference atrophy index (P0.05). 3. Lysholm score before operation and 1 week after operation. There was significant difference in Lysholm scores between the first week and the fifth week after operation (P0. 001). There was no significant difference between the two groups in VAS,BI scores before and 5 weeks after operation (P0.05) and BBS results (P0.05), 1 week after operation, there was no significant difference between the two groups (P0.05). There was no significant difference in the results of Lysholm scores and Lysholm scores 5 weeks after operation (P0.05), but the results of Lysholm scores in the experimental group were smaller than those in the control group (P0.05). Conclusion on the basis of routine rehabilitation therapy, the reconstruction training of knee joint position under visual digital software is beneficial to the recovery of proprioceptive sensation, the prevention of muscular atrophy and the improvement of the whole function of knee joint, and this method is simple and convenient. It is suitable for family rehabilitation and is worth popularizing and applying in clinic.
【學(xué)位授予單位】：南方醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R687.4
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