远程康复指导对全膝关节置换术后膝关节功能的影响

Effect of home tele-rehabilitation guidance on physical function of patients after TKA

目的:探讨远程指导的家庭康复治疗对全膝关节置换(TKA)术后患者膝关节功能恢复的影响。方法:TKA术后患者120例,随机分成观察组和对照组各60例,2组患者在住院期间均进行早期康复治疗,对照组出院后在家中继续延续院内训练方式自行训练。观察组患者在家通过远程家庭康复指导进行康复,两组患者均由同一康复治疗师在治疗前、术后1、3、6、9和12周,分别采用骨关节指数(WOMAC)、关节活动度(ROM)进行膝关节功能评定。结果:治疗1、3、6、9及12周后,2组WOMAC指数(疼痛,功能障碍,僵硬程度)均较治疗前明显下降(P<0.05),2组膝关节主、被动ROM均较治疗前明显提高(P<0.05);且观察组在出院后(治疗6、9及12周后),WOMAC指数(膝关节疼痛、功能障碍和僵硬程度)较对照组下降更显著(P<0.05),膝关节主、被动ROM较对照组提高更显著(P<0.05)。结论:远程指导的家庭康复治疗对TKA术后患者膝关节功能具有较好的疗效,值得临床推广。

Objective：To study the effects of home tele-rehabilitation guidance on function of knee in patients after total knee arthroplasty（TKA）.Methods：A total of 120 elderly patients who received a unilateral TKA were enrolled in this study.The participants were randomized into the control group and the rehabilitation group,both of which had finished rehabilitation while in hospital.The patients in the control group self-exercised after discharge,and those in the rehabilitation group received the home tele-rehabilitation guidance after discharge.WOMAC questionnaire score and ROM before and after the treatment were recorded respectively.Results：After treatment of 1,3,6,9and 12 weeks,the WOMAC scores of two groups were obviously decreased as compared with those of before（pain,dysfunction,stiff）（P〈0.05）,active and passive ROM scores of both groups increased obviously（P〈0.05）,and after treatment of 6,9and 12 weeks,WOMAC scores and active and passive ROM scores in rehabilitation group changed more than those in control group（P〈0.05）.Conclusion：Rehabilitation in hospital and home tele-rehabilitation guidance could significantly improve the patient＇s function of knee after TKA.