创伤性膝关节挛缩应用物理因子联合运动疗法治疗的临床效果

Clinical effects of physical agents combined with exercise therapy on traumatic knee joint contracture

目的探讨物理因子联合运动疗法治疗创伤性膝关节挛缩的临床疗效。方法选择2015年1月至2016年11月在安徽医科大学第二附属医院康复医学科就诊的以创伤性膝关节挛缩为第一诊断的患者45例,其中男性22例,女性23例;年龄11~61岁。随机分为治疗组和对照组。治疗组22例,其中男性10例,女性12例;年龄20~59岁,平均年龄38.90岁。对照组23例,其中男性12例,女性11例;年龄11~61岁,平均年龄32.74岁。均按照膝关节挛缩的治疗方案正规治疗,对照组行常规康复治疗(主要包括微波治疗、石蜡疗法、关节松动术、冷疗等),治疗组在此基础上同时行主被动运动疗法。比较两组患者治疗前后膝关节活动度和膝关节疗效评分有无差异,其中膝关节活动度以膝关节屈曲角度(°)表示,膝关节疗效评分以百分制(分)计。结果两组患者治疗前关节活动度(治疗组32.254 60°±11.401 41°,对照组33.386 70°±9.848 50°)差异无统计学意义(P>0.05);两组治疗后膝关节活动度(治疗组127.850 00°±13.554 78°,对照组97.562 50°±26.131 45°)与治疗前膝关节活动度比较,差异均有统计学意义(P<0.05);治疗组和对照组治疗后膝关节活动度差异有统计学意义(P<0.05)。两组患者治疗前膝关节疗效评分(治疗组34.545 50分±7.288 13分,对照组34.391 30分±7.709 14分)差异无统计学意义(P>0.05);两组患者治疗后膝关节疗效评分(治疗组87.636 40分±6.945 68分,对照组77.695 70分±5.611 96分)与治疗前膝关节疗效评分比较,差异均有统计学意义(P<0.05)。治疗组和对照组治疗后膝关节疗效评分差异有统计学意义(P<0.05)。结论物理因子联合运动疗法治疗可有效提高膝关节挛缩患者的膝关节活动度,提高膝关节疗效评分,改善膝关节功能。

Objective To investigate the clinical effects of physical agents combining with exercise therapy on patients with traumatic knee joint eontracture. Methods From January 2015 to November 2016, 45 patients with traumatic knee contracture diagnosed as the first diagnosis were selected from Department of Rehabilitation Medicine of the Second Affiliated Hospital of Anhui Medical University, which included 22 males and 23 females, aged 11 - 61 years old. The patients were randomly divided into treatment group（n = 22） and control group（n = 23）. Patients in treatment group included 10 males and 12 females, aged 20 - 59 years old with mean age of 38.90 years old; Patients in control group included 12 males and 11 females, aged 11 - 69 years old with mean age of 32.74 years old. All of them were treated in accordance with joint contracture treatment, the control group performed routine rehabilitation therapy（microwave therapy, paraffin therapy, joint mobilization technique and cold therapy） and treatment group was treated with active exercise therapy and continuous passive motion（CPM） at the same time. The range of motion and knee efficacy score before and after treatment between 2 groups were compared. The knee joint range of motion was expressed in the knee flexion angle（°）, and knee efficacy score was expressed in hundred-mark system（score）. Results The range of motion before treatment between 2 groups was no significant difference[treatment group （32.254 60 ± 11.401 41）°, control group （33.386 70 ± 9.848 50）°, P 〉 0.05]; the range of motion before treatment and after treatment between 2 groups was significant difference[treatment group （127.850 00± 13.554 78）°, control group （97.562 50 ± 26.131 45°）, P 〈 0.05 ]; the range of motion ＇after treatment between 2 groups was significant difference（P 〈 0.05）. The knee efficacy score before treatment between 2 groups was no significant difference（treatment group 34.545 50 ± 7.288 13, control group 34.391 30 ± 7.709 14, P 〉 0.05）; the knee efficacy score before and after treatment between 2 groups was significant difference（treatment group 87.636 40 ± 6.945 68, control group 77.695 70 ± 5.611 96, P 〈 0.05）; the knee efficacy score after treatment between 2 groups was significant difference（P 〈 0.05）. Conclusion It is demonstrated that physical agents combined with exercise therapy could effectively improve the range of motion and knee efficacy score, and improve knee joint function.