持续被动运动联合等速闭链训练对膝关节前交叉韧带重建术患者疼痛、关节活动度及运动功能的影响

Effects of Continuous Passive Motion Combined with Isokinetic Closed Chain Training on Pain,Joint Range of Motion and Motor Function of Patients after Knee Anterior Cruciate Ligament Reconstruction

目的评价持续被动运动联合等速闭链训练对膝关节前交叉韧带(ACL)重建术患者疼痛、膝关节活动度和运动功能的影响。方法选择2020年6月—2021年1月行膝关节ACL重建术115例为观察对象,根据康复训练方法不同分为对照组57例和观察组58例。对照组采用常规康复训练,观察组在对照组基础上采用持续被动运动联合等速闭链训练干预。比较两组干预后的疼痛视觉模拟评分法(VAS)评分、膝关节功能Lysholm评分、膝关节活动度、运动功能、临床疗效和并发症情况。结果干预4、8、12周后,两组VAS评分均低于干预前,且观察组低于对照组(P<0.05)。干预4、8、12周后,两组Lysholm评分和关节活动度均高于干预前,且观察组高于对照组(P<0.05)。干预后,观察组运动功能评级改善程度高于对照组(P<0.05)。观察组临床总有效率高于对照组(P<0.05)。两组并发症发生率比较差异无统计学意义(P>0.05)。结论持续被动运动联合等速闭链训练能够减轻ACL重建术患者疼痛,改善膝关节功能和运动功能,提高膝关节活动度和临床疗效。

Objective To evaluate effects of continuous passive motion combined with isokinetic closed chain training on pain,knee range of motion(ROM)and motor function of patients after knee anterior cruciate ligament(ACL)reconstruction surgery.Methods A total of 115 patients who had undergone knee ACL reconstruction surgery between June 2020 and January 2021 were selected and divided into control group(n=57)and observation group(n=58)according to different methods of rehabilitation training.Control group was given routine rehabilitation training,while observation group was given continuous passive motion combined with isokinetic closed chain training for intervention on the basis of treatment for control group.After intervention,visual analogue scale(VAS)pain score,knee function Lysholm score,knee ROM,motor function,clinical efficacy and incidence rate of complications were compared between two groups.Results After intervention for 4,8 and 12 weeks,VAS scores were significantly lower than those before intervention in two groups,and the scores in observation group were significantly lower than those in control group(P<0.05).After intervention for 4,8 and 12 weeks,Lysholm scores and joint ROM were significantly higher than those before intervention in two groups,and the scores and joint ROM in observation group were significantly higher than those in control group(P<0.05).The improvement degree of motor function in observation group was better than that in control group after intervention(P<0.05).The total effective rate in observation group was significantly higher than that in control group(P<0.05).There was no significant difference in incidence rate of complications between two groups(P>0.05).Conclusion Continuous passive motion combined with isokinetic closed chain training may relieve pain,improve knee function and motor function,and enhance the knee ROM and clinical efficacy for patients after ACL reconstruction surgery.