早期康复对下肢骨折致膝关节功能障碍患者骨密度影响的研究

Study Early Rehabilitation of Lower Limb Fractures Caused by Bone Mineral Density in Patients with Knee Dysfunction

目的观察早期康复训练对下肢骨折致膝关节功能障碍患者骨密度的影响。方法选择甘肃省康复中心医院康复科下肢骨折致膝关节功能障碍患者80例,随机分为康复组与对照组。康复组在术后4周开始进行早期康复治疗,包括主动、被动运动训练及不同物理治疗,持续20周;对照组在术后24周内未进行系统的康复训练。术后4/24周检测股骨、腰椎2~4、ward＇s区骨密度,并测量患者膝关节活动度。结果与结论无论是否进行早期运动康复训练及锻炼,下肢制动患者股骨、腰椎2~4以及ward区骨密度均下降,但康复组与对照组骨密度下降程度不同,康复组各部位骨密度的减少量均低于对照组（P〈0.01）,关节活动增加程度明显大于对照组（P〈0.01）,说明运动康复训练可以有效地减少下肢骨折患者康复期间骨矿物质的丢失,减少局部骨密度下降量,有效预防和改善失用性骨质疏松的情况。

Objective To investigate the effect of rehabilitation on BMD in patients with functional disorders of knee joint caused by lower limb fracture and compare the gender differences.Methods A total of 80 patients who had the dysfunction of knee joint caused by fracture of lower limb underwent internal or external fixation in Department of Rehabilitation,Tianjin Hospital.They were randomly assigned to rehabilitation and control groups.The rehabilitation group started rehabilitation training at 4 weeks after operation,including active exercise,passive exercise,and various physical therapies for 20 weeks.The control group did not do rehabilitation training during the 24 weeks.At 4and 24 weeks after operation,the BMD of femoral neck,L2-4 and ward＇s area in two groups was determined and range of motion of the knee joint was measured.Results and conclusion：BMD of femoral neck,L2-4 and ward＇s area in both groups decreased.But the BMD in rehabilitation group was greater than the control group（P0.01）,and the improvement in range of motion was significantly increased compared with the control group（P0.01）.The results showed that rehabilitation effectively attenuated bone mineral substance loss during rehabilitation from lower limb fracture,reduced BMD decrease,effectively prevented and improved osteoporosis due to immobilization.