PNF技术在肘关节骨折术后功能障碍中的应用

PNF technology after elbow joint bone fracture technique in function barrier application

目的：利用PNF技术治疗肘关节骨折术后功能障碍，探讨其对关节主／被动活动度、疼痛、肌肉力量和本体感觉的影响，并研究治疗关节内、外骨折的差异性。方法：选取肘关节骨折术后功能障碍患者共60例，患者术后病情稳定，视内固定牢固程度开始康复训练，最早术后3天开始，最迟术后2个月。分别分为关节内骨折，实验A组和对照B组；骨节外骨折实验C组和对照蛆D组。各纽患者接受关节松动术、肌力训练等系统性训练，实验A、C组追加PNF技术治疗。分别治疗8周后进行功能评价。结果：各组治疗前后主／被动关节活动度、VAS疼痛指数、肌力评定均具有统计学意义；治疗后A组与B组之间、C组与D组之闻比较亦有统计学意义。A组与C组本体感觉治疗前后具有统计学意义，治疗后A组与B组之间、C组与D组之间本体感觉比较亦有统计学意义，B、D组治疗前后本体感觉无统计学意义。关节外骨折与关节内骨折对比，治疗后A、C组屈曲、旋前主／被动角度、旋后主动角度相比具有统计学意义，B、D纽屈曲主／被动角度具有统计学意义；各肌群肌力和本体感觉变化无统计学意义。结论：PNF对肘关节骨折术后功能障碍有明显疗效，对肘关节主／被动关节活动度、肌肉力量、本体感觉和疼痛缓解都有促进作用。

Objective： Our aim is to study the effectiveness of PNF on AROM/PROM, pain, muscle strength, proprioception, and variability between extra--articular fracture of elbow and the intra--articular fracture of elbow. Methods：60 patients with dysfunction of elbow fracture after operation, who were in stabilized condition, were performed rehabilitation exercise according to condition of internal fixation. The earliest patient began from the 3rd day postoperation, the latest patient began from the 3rd month postoperation. All patients were divided randomly into the extra--articular fracture group and the intra--articular fracture group,the former was included experimental group A and the control group B,the latter was ineluded experimental group C and the control group D. In conventional therapy,all groups were performed by systematic rehabilitation exercise on Joint Mobilization,muscle strength exercise and so on. In addition to this,the experimental groups A,C were treated by PNF. After 8 weeks, every one had a functional assessment. Results： Pre and post treatment, the difference of the AROM/PROM, the VAS score and muscle evaluation of all groups had statistical significance;post treatment, the difference of these between the group A and B, C and D, bad statistical significance. Pre and post treatment, proprioception of groups A and C had statistical significance. Post treatment, prorioeeption of groups A and B, C and D had statistical significance, too. Pre and post treatment, proprioception of groups B and D didn＇t have statistical significance. In the extra--articular fracture group compared with the intra--articular fracture group, post treatment,the inflexed, pronated AROM/PROM and supine AROM of groups A and C,the inflexed AROM/PROM of groups B and D had statistical significance;the muscle strength and proprioception of all groups didn＇t have statistical significance. Conclusion： PNF was effective in treating dysfunction after elbow fracture. The effectiveness of AROM/PROM, easement of pain, muscle strength and proprioeeption was improved.