术侧肌力训练对老年全膝关节置换术患者下肢功能的影响

Effect of Postoperative Muscle Strength Training on Lower Limb Function in Elderly Patients Undergoing Total Knee Arthroplasty

目的:观察下肢髋膝踝关节肌力训练对全膝关节置换术后老年患者术侧下肢功能的影响。方法:将141例全膝关节置换术后老年患者分为观察组71例和对照组70例。对照组给予常规康复练习和负重训练,观察组在对照组的基础上给予术侧下肢髋膝踝关节肌力训练。2组疗程均为3个月。观察2组患者训练前后平衡功能[采用Berg平衡量表(BBS)评分评价],步态效能[包括患足支撑时间百分比、标准化步幅、步频、坐站转换时间(STS)和改良步态效能评分(mGES)],下肢运动功能重建指标[包括移动能力(TUGT)、最大步行速度(MWS)和跌倒指数(FI)]。结果:训练后,2组患者平衡功能、步态效能、下肢运动功能重建各项指标明显优于训练前(P<0.05),且观察组明显优于对照组(P<0.05)。结论:下肢髋膝踝关节肌力训练能通过对下肢肌肉的肌力训练,提高全膝关节置换术后老年患者的平衡功能,改善其步态效能,提高下肢运动功能重建指标,值得临床运用。

Objective:To observe the effect of muscle strength training for lower limb hip,knee and ankle on lower limb function of elderly patients after total knee arthroplasty.Methods:One hundred and forty-one elderly patients after total knee arthroplasty were divided into an observation group(71 cases)and a control group(70 cases).The control group was given routine rehabilitation exercise and weight-bearing training,and the observation group was given muscle strength training for hip,knee and ankle on the basis of the control group.The course of treatment for both groups was 3 months.The balance function before and after training(evaluated by BBS),gait efficiency(percentage of patient foot support time,standardized stride,gait frequency,STS and MGEs),and lower limb motor function reconstruction index(TUGT,MWS and FI)were observed.Results:After training,the indexes of balance function,gait efficiency and lower limb motor function reconstruction in the two groups were significantly better than those before training(P<0.05),and the observation group was significantly better than that in the control group(P<0.05).Conclusion:Muscle strength training for lower limb hip,knee and ankle can improve the balance function of elderly patients after total knee arthroplasty,improve their gait efficiency and improve the reconstruction index of lower limb motor function,worthy of clinical application.