桡骨远端骨折石膏固定后早期康复锻炼对PRWE评分肿胀评分及腕关节功能的影响

Effect of Early Stage Rehabilitation Exercise on PRWE Score Swelling Score and Wrist Function After Plaster Fixation of Distal Radius Fractures

目的:桡骨远端骨折石膏固定后早期康复锻炼对PRWE评分、肿胀评分及腕关节功能的影响。方法:选取2016年8月至2019年2月本院收治的桡骨远端骨折患者426例,按照简单随机数字表法分分为对照组、研究组各213例。对照组患者在石膏固定后给予常规自主锻炼,研究组患者给与早期康复锻炼。于7d后观察两组肿胀评分差异,3个月后观察两组PRWE评分、腕关节功能差异。结果:重复测量方差分析显示,两组患者在肿胀评分的时点、组间、时点与组别的交互效应均差异有统计学意义(P<0.05)。治疗前,两组肿胀评分比较差异无统计学意义(P>0.05);治疗7d后,研究组肿胀评分改善程度更大,差异有统计学意义(P<0.05)。两组患者PRWE评分的时点、组间、时点与组别的交互效应均差异有统计学意义(P<0.05)。治疗前,两组肿胀评分PRWE评分比较差异无统计学意义(P>0.05);治疗3月后,研究组PRWE评分变化程度更高,差异有统计学意义(P<0.05)。等级秩和检验结果显示:两组在主观活动度、捏力、握力总体四个等级程度比较无明显差异(P>0.05),但研究组患者主观活动度、捏力、握力优良合计显著高于对照组(P<0.05)。结论:早期康复锻炼运用于桡骨远端骨折患者石膏固定后,效果明确,有助于缓解术后肿胀,改善PRWE评分,加快患者腕关节功能恢复,但进行锻炼时需注意训练频率与程度的把控。

Objective:To study the effect of early stage rehabilitation exercise on PRWE score,swelling score and wrist function after plaster fixation of distal radius fractures.Methods:A total of 426 patients with distal radius fracture hospitalized from August 2016 to February 2019 were selected and divided into control group and study group with the simple random number table,213 cases in each group.Patients in the control group had regular exercise after plaster fixation,and patients in the study group had early stage rehabilitation exercise.After 7 days,the difference of swelling score between the two groups was observed.After 3 months,the difference of PRWE score and wrist function between the two groups was observed.Results:Analysis of variance of repeated measurements showed that there was significant difference between the two groups in the interaction effect of swelling score(P<0.05).There was no significant difference between swelling scores of the two groups before treatment(P>0.05);after 7 days of treatment,the swelling score of the study group was improved more significantly(P<0.05).There were significant differences in the interaction of time points,groups,time point and group in the two groups(P<0.05).There was no significant difference between the two groups in swelling score and PRWE score before treatment(P>0.05),and the PRWE score of the study group was higher 3 months after treatment(P<0.05).The results of rank sum test showed that there was no significant difference between the two groups in the four grades of subjective activity,kneading force and grip strength(P>0.05),but the total subjective activity,kneading force and grip strength of the patients in the study group were significantly higher than those in the control group(P<0.05).Conclusion:Early rehabilitation exercise has definite effect on distal radius fractures after plaster fixation,which is helpful to relieve postoperative swelling,improve PRWE score,and speed up the recovery of wrist function.However,attention should be paid to the control of training frequency and degree during exercise.