远程康复督导结合冲击波治疗在踝关节术后康复中的应用

Application of remote rehabilitation supervision combined with shock wave therapy in postoperative rehabilitation of ankle joint surgery

远程康复督导是一种基于互联网的新型康复模式,冲击波治疗(ESWT)是骨科疾病的新型康复技术。以踝关节创伤术后患者为研究对象,通过前瞻性临床对照研究,明确了远程康复督导结合ESWT对踝关节创伤术后功能康复及预后的影响。指标包括:疼痛的视觉模拟量表(VAS)、踝关节功能的美国足踝学会踝后足评分(AOFAS)及预后距骨软骨损伤(OLT)发生率。踝关节术后远程康复的并发症发生率为43.4%(33/76),后续ESWT可显著降低并发症组患者的VAS,提高AOFAS,其术后1年的VAS、AOFAS、OLT发生率与对照组(无并发症组)之间无显著差异,说明ESWT可显著改善康复期并发症患者的疼痛及关节功能,提高其康复进度,有效抑制OLT的发生,最终达到与对照组一致的康复水平。

Remote rehabilitation supervision is a new type of rehabilitation mode based on internet technology,and extracorporeal shock wave therapy(ESWT)is a new rehabilitation technique for orthopedic diseases.This prospective clinical controlled study focuses on the post-operative patients with ankle joint trauma and aims to clarify the impact of remote rehabilitation supervision combined with ESWT on the postoperative functional recovery and prognosis.The indicators included the visual analog scale(VAS)for pain,the American Foot and Ankle Association ankle posterior foot score(AOFAS)for ankle joint function,and the prognostic incidence of osteochondral lesion of the talus(OLT).The patients'complication incidence during the remote rehabilitation was 43.4%(33/76),and the subsequent ESWT could significantly reduce VAS and increase AOFAS in those patients of complication group,while the incidences of VAS,AOFAS,and OLT did not have significantly differences between the complication group and control group(patients without rehabilitation complication)one year after surgery.It indicates that ESWT can significantly improve the pain and joint function,inhibit the occurrence of OLT,as well as enhance recovery of the patients with complications during the recovery period,ultimately making them reach the same rehabilitation outcome as the control group.