等速肌力联合本体感觉训练用于全膝关节置换术后康复的价值

Value of Isokinetic Muscle Strength Combined with Proprioception Training for Rehabilitation after Total Knee Arthroplasty

目的:观察等速肌力联合本体感觉训练用于全膝关节置换术(TKA)后康复的价值。方法:选取2018年12月-2019年12月南京市中医药大学附属南京医院骨科收治的84例需进行TKA的单侧膝关节炎患者。按照随机数表法将其分为观察组与对照组,各42例。对照组进行本体感觉训练,观察组在进行本体感觉训练的基础上同时进行等速肌力训练。对比两组治疗前及治疗3周后视觉模拟评分法(VAS)评分、美国特种外科医院(HSS)膝关节评分、膝关节角度及平衡功能,对比两组治疗前及治疗1、2、3周后膝部肌力最大功率(MP)。结果:治疗3周后观察组静止、活动VAS评分均显著低于对照组(P<0.05)。治疗3周后观察组肌力、疼痛、活动度、功能、稳定、屈曲畸形评分均显著高于对照组(P<0.05)。治疗3周后观察组膝关节摆动角度大于对照组,膝关节支撑角度小于对照组,Berg评分高于对照组(P<0.05)。治疗1、2、3周后观察组MP均显著大于对照组(P<0.05)。结论:等速肌力及本体感觉训练均可有效改善膝关节炎患者术后平衡功能及肌肉功能,同时两种训练相互配合效果优于单一进行本体感觉训练。

Objective:To observe the value of isokinetic muscle strength combined with proprioception training for rehabilitation after total knee arthroplasty(TKA).Method:From December 2018 to December 2019,a total of 84 patients with unilateral knee arthritis requiring TKA admitted to department of orthopedics in Nanjing Hospital Affiliated to Nanjing University of Traditional Chinese Medicine were selected.According to the random number table method,they were divided into observation group and control group,42 cases in each group.The control group received proprioception training,and the observation group received isokinetic muscle strength training on the basis of proprioception training.Visual analogue scale(VAS)score,Hospital for Special Surgery(HSS)knee joint score,knee joint angle and balance function were compared between the two groups before and after 3 weeks of treatment,and the knee muscle strength maximum power(MP)was compared between the two groups before treatment and after 1,2 and 3 weeks of treatment.Result:After 3 weeks of treatment,the VAS scores of rest and activity in observation group were significantly lower than that in control group(P<0.05).After 3 weeks of treatment,the scores of muscle strength,pain,activity,function,stability and flexion deformity in the observation group were significantly higher than those in the control group(P<0.05).After 3 weeks of treatment,the knee joint swing angle of the observation group was greater than that of the control group,the knee joint support angle of the observation group was smaller than that of the control group,and the Berg scores of the observation group was higher than that of the control group(P<0.05).After 1,2 and 3 weeks of treatment,MP in observation group were significantly greater than those in control group(P<0.05).Conclusion:Both isokinetic muscle strength and proprioception training can effectively improve postoperative balance function and muscle function in patients with knee arthritis.Meanwhile,the interaction effect of the two kinds of training is better than that of proprioception training alone.