早期减重步态训练对前交叉韧带重建术后下肢步行功能的影响

Effects of early partial body-weight support gait training on the walking function of lower extremities of patients with anterior cruciate ligament reconstruction

目的:探讨前交叉韧带重建术后早期减重(PBWS)步态训练对下肢步行功能及膝关节稳定性的影响。方法:将膝关节前交叉韧带重建术后患者41例分为治疗组20例及对照组21例,术后分别进行常规训练加减重步态训练和常规康复训练。术后12周、6个月进行小腿周径测定、Holden步行功能分级、10m步行时间测定、国际膝关节文献委员会膝关节评估表(IKDC)评分,术后6个月进行KT-1000关节稳定性检查。结果:术后12周治疗组Holden步行功能分级、10m步行时间、健患小腿周径差、IKDC评分与对照组之间差异具有显著性的意义(P<0.05),术后6个月,各项指标及KT-1000检查两组之间的差异无显著性的意义(P>0.05)。12周时治疗组与6个月时对照组相比Holden步行功能分级、10m步行时间、小腿周径差差异无显著性意义(P>0.05)。结论:前交叉韧带重建术后早期加入减重步态训练能较早促进下肢功能恢复,提高步行能力,同时也不影响近期膝关节稳定性。

Objective： To evaluate the effects of early partial body weight support（PBWS） gait training on the walking function of lower extremities and stabilization of the knee of patients with anterior cruciate ligaments reconstruction.Method： Forty-one patients with anterior cruciate ligaments reconstruction were divided into early PBWS gait training group（20 subjects） and control group（21 subjects）. Early PBWS gait training and conventional rehabilitation training were used after operation, respectively. Circumferential length of lower extremities, Holden classification, 10 meter walking time（10MWT）, International Knee Documentation Committee（IKDC） knee assessment were recorded at 12 weeks and 6 months after operation. And KT-1000 knee joint stability test was performed 6 months after the operation.Result：Significant differences were found in Holden classification, 10 MWT, circumferential length of legs and IKDC between two groups（P0.05） 12 weeks after operation. No significant difference was found in any parameters mentioned above（including KT-1000 tests） between two groups（P0.05） at the 6th month post-operation. Circumferential length of lower extremities, Holden classification, 10 WMT comparing between treatment group in the 12 th week and control group in the 6th month were insignificant（P0.05）.Conclusion： After anterior cruciate ligament reconstruction surgeries, early introduction to PBWS gait training can improve the walking function of lower extremities. It can promote the patient＇s walking ability without compromising the stabilities of knee joints in given follow-up period.