处方量化锻炼在指屈肌腱断裂术后功能康复中的应用

Application in functional exercise after repairing ruptured flexor digit tendon with measurable active mobilization

目的制定指屈肌腱断裂伤主动锻炼的要素和流程，以提高疗效。方法归纳出主动锻练运动剂量的3个要素：肌肉收缩力量、次数、每次肌肉收缩的持续时间；每天的运动量在不同时刻分组实施。本组53例食指指屈肌腱Ⅱ区切割断裂伤患者，手术修复后的45天内，将肌腱愈合过程分为四个阶段，对应给予四个运动处方指导锻炼。全过程好似用量化的运动之“药”治疗肌腱粘连之“病”，故称之“处方锻炼法”。结果患者在3min内可学会当天的锻炼内容并自主实施。术后45天，PIP关节活动度〉15。者31例：PIP关节活动度〉50者20例；1例由于疼痛综合征，无PIP关节活动度；1例由于瘢痕体质．无PIP关节活动度。结论主动锻炼可以量化控制。处方锻练法在指屈肌腱断裂伤早期康复中有良好疗效。

Objective To identify the elements and procedure of active mobilization after repairing lacerated flexor tendon for improving clinical efficiency. Methods Three elements of measurable active mobilization were identified. They were contractile force, frequency and duration of the muscle. The amount of exercise was determined by the time after the operation. 53 patients with lacerated flexor tendon in zone ]I underwent repair. Within 45 days after operation, four stages were divided according to the healing process of flexor tendon. Consequently, four exercise prescriptions as exercise guidelines were given to the patients. It named measurable active mobilization was because of the procedure of active mobilization can be measurable for prevention of flexor tendon adhesion. Results All patients could learn how to carlT out independently within three minutes. The range of motion of PIP was more than 15° in 31 patients. The range of motion of PIP was more than 5° in 20 patients. 2 patients did not move PIP, one owing to the pain syndrome, anther owing to scar diathesis. Conclusion Active mobilization can be measurable to control. This method can offer good outcome in early rehabilitation of lacerated flexor tendon.