Otago运动对老年全膝关节置换术后患者恐动程度及跌倒风险的影响

Effect of Otago exercise programme on kinesiophobia and falling risk in elderly patients with knee arthroplasty

目的探讨Otago运动对老年全膝关节置换术后患者恐动程度及跌倒风险的影响。方法将2015年9月-2018年3月我院收治的100例行全膝关节置换术的老年患者随机分为干预组和对照组,各50例,对照组采用常规康复锻炼,干预组在对照组基础上实施Otago运动训练。采用恐动症Tampa评分(TSK)、Berg平衡量表(BBS)、纽约特种外科医院膝关节评分(HSS评分)、日常生活活动能力量表(ADL)评价2组患者康复效果。结果干预组和对照组TSK得分、BBS得分、HSS得分、ADL得分的分组主效应差异有统计学意义(P<0.05),时间主效应差异有统计学意义(P<0.05),干预组和对照组TSK得分、HSS得分、ADL得分的时间和分组交互效应差异有统计学意义(P<0.05),但两组BBS得分的时间和分组交互效应差异无统计学意义(P>0.05)。出院1个月、3个月干预组TSK得分明显低于对照组,BBS得分和HSS得分明显高于对照组;出院1个月干预组ADL得分明显低于对照组,差异均有统计学意义(均P<0.05)。结论 Otago运动可以降低老年TKA患者术后恐动程度和跌倒风险,并促进膝关节功能恢复和改善患者日常活动功能。

Objective To investigate the effect of Otago exercise programme on kinesiophobia and falling risk in elderly patients with knee arthroplasty. Methods A total of 100 elderly patients who underwent knee arthroplasty were randomly divided into intervention group and control group. The routine functional exercise instruction and the OEP were implemented in the control group and intervention group, respectively. The Tampa scale for kinesiophobia(TSK),Berg balance scale(BBS),special surgical hospital knee scoring criteria(HSS) and daily activity ability scale(ADL) was used to assessed between two groups. Results The interventional main effect and time main effect of TSK,BBS,HSS and ADL scores was statistically significant between intervention group and control group(P<0.05). In addition,the intervention and time crossover effect of TSK,HSS,ADL scores was statistically significant between groups(P<0.05). However,those effect was no statistically significant in BBS scores between groups(P>0.05). At 1 th month,3 th month after discharge,TSK scores were significantly decreased in the intervention group compared to the control group, BBS and HSS scores were significantly increased in the intervention group compared to the control group. At 3 th month after discharge,ADL scores were significantly decreased in the intervention group compared to the control group(all P<0.05). Conclusion Otago exercise programme can alleviate kinesiophobia and falling risk as well as improve knee joint function recovery and daily activity ability of elderly patients with knee arthroplasty.