强化本体感觉训练配合康复路径在膝关节交叉韧带断裂半月板损伤患者术后康复中的应用

Application of strengthening proprioceptive training combined with rehabilitation path in postopera-tive rehabilitation of patients with knee cruciate ligament rupture and meniscus injury

目的探讨强化本体感觉训练配合康复路径在膝关节交叉韧带断裂半月板损伤患者术后康复中的应用效果。方法前瞻性收集2019年4月至2021年2月我院96例膝关节交叉韧带断裂半月板损伤患者,年龄(39±4)岁,男66例(68.75%),女30例(31.25%)。根据抽签法随机分为常规组(n=48)、联合组(n=48),分别采取常规康复和康复路径+强化本体感觉方法训练8周。统计两组不良事件及训练前后患膝关节位置(中间段、伸展段、屈曲段)重现偏差、运动控制能力、步行功能、膝关节功能、疼痛程度。结果96例患者获得随访,随访时间6~12个月,平均(9.11±0.68)个月。(1)训练8周后联合组伸展段、中间段、屈曲段患膝关节位置重现偏差(4.02±1.15、4.05±0.89、4.11±0.94)低于常规组(4.61±1.20、4.72±0.93、4.78±0.87),VL、RF、VM的RMS(75.61±5.62、80.52±6.71、74.48±5.12)高于常规组(67.79±6.17、74.12±5.94、68.95±5.56)(P<0.05);(2)训练8周后联合组运动控制能力、步行功能评分、膝关节功能评分高于常规组,疼痛程度评分低于常规组(P<0.05);(3)联合组不良事件发生率8.33%与常规组4.17%比较,差异无统计学意义(P>0.05)。结论强化本体感觉训练配合康复路径可改善膝关节交叉韧带断裂半月板损伤患者表面肌电图,缓解疼痛,提高运动控制能力及步行能力,恢复膝关节功能。

Objective To explore the application effect of strengthening proprioceptive training combined with rehabilitation path in postoperative rehabilitation of patients with knee cruciate ligament rup-ture and meniscus injury.Methods From April 2019 to February 2021,96 patients with cruciate ligament rupture and meniscus injury in our hospital,aged(38.93±4.56)years old,were prospectively collected,in-cluding 66 males(68.75%)and 30 females(31.25%).According to the lottery method,they were randomly divided into a conventional group(n=48)and a combined group(n=48),and were trained for 8 weeks with conventional rehabilitation and rehabilitation path+enhanced proprioceptive method respectively.The ad-verse events and the position of the knee joint(intermediate segment,extension segment,and flexion seg-ment)recurrence deviation,motor control ability,walking function,knee joint function,and pain degree be-fore and after training were counted in the two groups.Results 96 patients were followed up for 6 to 12 months,with an average of(9.11±0.68)months.(1)After 8 weeks of training,the position recurrence devia-tion of the knee joint in the joint group in extension,middle and flexion segments(4.02±1.15,4.05±0.89,4.11±0.94)was lower than that in the conventional group(4.61±1.20,4.72±0.93),4.78±0.87),the RMS of VL,RF and VM(75.61±5.62,80.52±6.71,74.48±5.12)were higher than those of the conventional group(67.79±6.17,74.12±5.94,68.95±5.56)(P<0.05).(2)After 8 weeks of training,the motor control ability,walk-ing function score and knee joint function score of the combined group were higher than those of the conven-tional group,and the pain score was lower than that of the conventional group(P<0.05).(3)The incidence of adverse events in the combined group was 8.33%and Compared with 4.17%in the conventional group,the difference was not statistically significant(P>0.05).Conclusions Strengthening proprioceptive training combined with rehabilitation path can improve the surface electromyogram of patients with knee cruciate lig-ament rupture and meniscus injury,relieve pain,improve motor control ability and walking ability,and re-store knee joint function.