康复治疗联合等速肌力训练对全膝关节置换术后患者膝关节功能的影响

Effect of rehabilitation therapy combined with isokinetic muscle strength training on knee joint function of patients after total knee arthroplasty

目的探讨常规康复治疗联合等速肌力训练对全膝关节置换术(TKA)后患者膝关节疼痛程度、膝关节被动活动度(PROM)、膝关节功能及股四头肌肌力的影响。方法选择2020年1月至2022年1月河南省直第三人民医院收治的99例行TKA的膝骨关节炎患者为研究对象,采用随机数字表法将患者分为观察组(n=50)和对照组(n=49)。对照组患者行TKA术后给予常规康复治疗,观察组患者行TKA术后给予常规康复治疗联合等速肌力训练,2组患者均连续治疗12周。治疗前及治疗4、12周时,采用视觉模拟评分法(VAS)对2组患者的膝关节疼痛程度进行评估,采用量角器测量膝关节屈伸PROM,采用徒手肌力检查(MMT)评估2组患者的股四头肌肌力,采用膝关节功能评估量表(HSS)评估2组患者的膝关节功能。结果治疗前2组患者的膝关节VAS评分、HSS评分、PROM度数及股四头肌肌力评分比较差异均无统计学意义(P>0.05)。2组患者治疗4周时的膝关节VAS评分、HSS评分、PROM度数及股四头肌肌力评分与治疗前比较差异无统计学意义(P>0.05)。2组患者治疗12周时的膝关节VAS评分显著低于治疗前,HSS评分、PROM度数及股四头肌肌力评分显著高于治疗前(P<0.05)。治疗4周时,2组患者的膝关节VAS评分、HSS评分、PROM度数及股四头肌肌力评分比较差异无统计学意义(P>0.05)。治疗12周时,观察组患者的膝关节VAS评分显著低于对照组,HSS评分、PROM度数、股四头肌肌力评分显著高于对照组(P<0.05)。结论TKA术后常规康复治疗联合等速肌力训练能进一步缓解患者疼痛,增强膝关节功能,促使患者快速恢复。

Objective To explore the effect of routine rehabilitation therapy combined with isokinetic muscle strength training on pain degree,passive range of motion(PROM),function of knee joint and quadriceps femoris muscle strength of patients after total knee arthroplasty(TKA).Methods A total of 99 knee osteoarthritis patients who underwent TKA in the Third People′s Hospital of Henan Province from January 2020 to December 2022 were selected as the study subjects.The patients were divided into observation group(n=50)and control group(n=49)by random number table method.The patients in the control group were given routine rehabilitation treatment after TKA,and the patients in the observation group were given routine rehabilitation treatment combined with isokinetic muscle strength training after TKA.The pain degree of knee joint of patients in the two groups was evaluated by visual analogue scale(VAS),the PROM of knee flexion and extension was measured by protractor,the quadriceps femoris muscle strength of knee joint of patients in the two groups was evaluated by hand muscle strength test,and the knee joint function of patients in the two groups was evaluated by hospital for special surgery knee score(HSS)scale before treatment,4 weeks after treatment and 12 weeks after treatment.Results There was no significant difference in the VAS scores,HSS scores,PROM degree of knee joint and quadriceps femoris muscle strength of patients between the two groups before treatment(P>0.05).There was no significant difference in the VAS scores,HSS scores,PROM degree of knee joint and quadriceps femoris muscle strength of patients before treatment and after 4 weeks of treatment(P>0.05).The VAS score of knee joint of patients after 12 weeks of treatment was significantly lower than that before treatment,while the HSS scores,PROM degree of knee joint and quadriceps femoris muscle strength of patients were significantly higher than those before treatment(P<0.05).At 4 weeks of treatment,there was no significant difference in the VAS scores,HSS scores,PROM degree of knee joint and quadriceps femoris muscle strength of patients between the two groups(P>0.05).At 12 weeks of treatment,the VAS score of knee joint of patients in the observation group was significantly lower than that in the control group,while the HSS scores,PROM degree of knee joint and quadriceps femoris muscle strength of patients were significantly higher than those in the control group(P<0.05).Conclusion Routine rehabilitation therapy combined with isokinetic muscle strength training after TKA can further relieve pain,enhance knee joint function and promote rapid recovery of patients.