MOTOmed智能运动训练结合神经肌肉本体感觉促进技术对全膝关节置换术后功能恢复的影响

Effects of MOTOmed intelligent motor training and proprioceptive neuromuscular facilitation on postoperative function recovery in total knee arthroplasty

目的观察MOTOmed智能运动训练结合神经肌肉本体感觉促进技术(PNF)对全膝关节置换术(TKA)后患者膝关节功能恢复及平衡功能的疗效和安全性。方法前瞻性收集2015年01月至2015年12月江苏省扬州苏北人民医院行择期TKA术后的患者45例,随机分为治疗组(n=23)和对照组(n=22),两组患者均进行4周康复训练,主要内容包括康复教育、肌力、关节活动度、站立平衡训练及物理因子治疗等。对照组采取常规训练方法进行康复训练,治疗组在对照组的基础上应用MOTOmed智能运动训练系统和PNF技术进行康复训练。随访并比较两组患者的美国特种外科医院(HSS)膝功能评分及Berg平衡量表评分(BBS)。结果治疗4周后,治疗组和对照组患者HSS评分分别由治疗前的(50.6±4.8)分和(51.7±4.5)分改善至(90.1±4.3)分和(83.5±3.9)分,差异有统计学意义(t=-5.658,t=-4.269,P<0.05);其中治疗组膝关节功能和稳定性评分为(19.1±1.1)分和(8.4±1.6)分,优于对照组的(17.0±1.3)分和(7.2±1.5)分,差异均有统计学意义(t=-3.659,t=-2.536,P<0.01)。治疗组和对照组患者治疗4周后BBS评分分别为(53.8±1.7)分和(50.1±1.9)分,优于治疗前的(45.6±2.9)分和(46.1±3.3)分,差异均有统计学意义(t=-2.514,t=-2.127,P<0.05)。治疗前两组患者评分没有差异(t=-0.324,P=0.153),而治疗后治疗组评分优于对照组,差异有统计学意义(t=-7.658,P<0.01)。结论 MOTOmed智能运动训练结合PNF技术能有效改善TKA术后患者膝关节的关节稳定性和运动控制能力,提高患者平衡功能。

Objective To observe the effects of MOTOmed intelligent motor training combined with proprioceptive neuromuscular facilitation (PNF) on knee function recovery and balance in patients underwent total knee arthroplasty (TKA). Methods Forty- five patients with elective TKA in Northern Jiangsu People’s Hospital between January 2015 and December 2015 were included in a prospective study.They were randomly divided into treatment group (n=23) and control group (n=22), both groups were given a 4 weeks of rehabilitation training, which mainly include rehabilitation, education training, muscle strength training, range of motion, standing balance training and physical therapy. Patients in control group conducted conventional rehabilitation and the treatment group with additional MOTOmed intelligent motor training and PNF. The hospital for special surgery knee score (HSS) and Berg Balance Scale (BBS) were followed up and compared between two group. Results After 4 weeks treatment, the HSS scores of the treatment group and control group were improved to (90.1±4.3) points and (83.5±3.9) points from before treantment [(50.6±4.8) points and (51.7±4.5)] points with statistical significance (t=-5.658, t=-4.269, P<0.05); The knee function and stability score in the treatment group were (19.1 ± 1.1) and (8.4 ± 1.6) points , higher than that of the control group [(17.0±1.3) points, (7.2±1.5) points] with statistical significance (t=-3.659, t=-2.536,P<0.01). The BBS scores of two groups were (53.8±1.7) points and (50.1±1.9) points conpared to [(45.6±2.9)points and (46.1±3.3)] points preoperatively, differences were statisticaliy significant (t=-2.514, t=-2.127,P<0.05), the preoperative innergroup comparison of the BBS scores had no statistical differences, but the post-therapy score of the treatment group was higher than the control group with statistical significance (t=-7.658, P<0.01). Conclusion MOTOmed intelligent motor training combined with PNF can significantly improve the joint stability, knee motion, control capabilities and balance function in patients underwent TKA.