运动贴扎技术对急性踝关节外侧韧带损伤患者早期康复的影响

Therapeutic effectiveness of kinesio taping for early rehabilitation in patients with acute ankle lateral liga⁃ment injury

目的:探讨运动贴扎技术对急性踝外侧韧带损伤后患者踝关节早期康复的影响。方法:将符合入选标准的90例踝关节扭伤患者按随机数字表法分为实验组(A组)、安慰剂组(B组)、对照组(C组),每组30例。C组接受常规治疗(1次/d,30min/次,5d/周,共2周);A组、B组除常规治疗外(1次/d,30min/次,5d/周,共2周),同一天分别给予运动贴扎技术治疗、无拉力白贴(安慰剂)治疗(1次/d,5d/周,共2周)。三组患者均给予常规康复运动训练指导及健康教育,并在接受治疗前、治疗2周后进行患侧肢体平衡功能[X轴平均位移(Mcd)、Y轴平均位移(Msd)评分]、损伤韧带厚径及相关肌群表面肌电值[腓肠肌外侧头(GL)、腓肠肌内侧头(GM)、腓骨长肌(PL)评分]的评定。结果:治疗前,三组患者患侧肢体各项评分比较差异均无显著性意义(P>0.05)。治疗2周后,组内前后比较,①表面肌电评估,即以相关肌群标准化肌电募集程度(均方根值RMS)为单位,测定步态项中肌群的肌电值:A、B两组表面肌电评分(GL、GM、PL)均较治疗前改善(P<0.05),但C组三块肌肉评分较治疗前差异均无显著性意义;②平衡功能评估:A组、C组平衡功能Mcd、Msd评分较治疗前差异均有显著性意义,且A组较前改善(P<0.005)、C组较前下降(P<0.001),B组Mcd评分较治疗前改善(P<0.001),但B组Msd评分较治疗前差异无显著性意义(P>0.05);③韧带厚径评估:三组韧带厚径评分均较治疗前改善(P<0.001)。治疗2周后,组间比较,A组韧带厚径评分、表面肌电评分(GL、GM、PL)均优于B组和C组(P<0.01);A组平衡功能评分(Mcd、Msd)均优于C组(P<0.005)、Msd评分优于B组(P<0.05),但Mcd评分与B组比较差异无显著性意义(P>0.05);B组仅平衡功能评分(Mcd、Msd)优于C组(P<0.001),B、C两组其他评分比较差异均无显著性意义(P>0.05)。结论:运动贴扎技术治疗可提高踝关节外侧韧带损伤患者平衡控制能力和相应肌群功能,加速损伤韧带的恢复。

Objective:To figure out the effect of kinesio taping for early rehabilitation in patients with acute ankle lateral ligament injury.Method:In this study,90 patients were enrolled.They were diagnosed as ankle sprain within 7 days in orthopedics and rehabilitation department.Patients were randomly divided into 3 groups:an observation group(Group A),a placebo group(Group B)and a control group(Group C).There were 30 patients in each group.Group C was given conventional therapy(5 times a week,once a day,30 mins/time,for 2 weeks),Group A was treated with kinesio taping+conventional therapy,Group B was treated with non-tension white taping(placebo)+conventional therapy.Group A and Group B received treatments 5 times a week,once a day,for 2 weeks.The three groups were given routine rehabilitation exercise and health education.Before and at the end of treatment,the balanced function(Mcd and Msd),ligament thickness and diameter,and surface electromyography of related muscles(GL,GM and PL)of the 3 groups were measured and assessed.Result:The results showed that the P value of the assessment scores of the three groups were>0.05,which were comparable.After two weeks of treatment:①The surface EMG assessment scores of GL,GM,PL were improved after treatment in Group A and Group B(P<0.05),but not in Group C(P>0.05).②The scores of balance function(Mcd,Msd)in group A were significantly increased after treatment(P<0.005),but reduced in group C(P<0.001).The Mcd scores in Group B were improved after treatment(P<0.001),and there was no improvement in the Msd scores in Group B.③The ligament thickness and diameter assessment scores of all 3 groups were significantly improved(P<0.001).After two weeks treatment,the improvement of ligament thickness and diameter scores and surface electromyography(GL,GM and PL)scores in group A were better than that in group B and C(P<0.01).The scores of balance function(Mcd,Msd)in Group A were higher than Group C(P<0.005),the Msd scores of Group A were higher than Group B(P<0.05)and the Mcd scores were no significant difference between Group A and Group B(P>0.05).Only the scores of balance function(Mcd,Msd)in Group B were higher than Group C(P<0.001),and there were no significant difference in other assessment scores between Group B and Group C.Conclusion:Kineso taping could improve balance control and relevant muscle function of the ankle joint,and accelerate the repair of damaged ligaments.