视觉反馈下平衡训练对全膝关节置换术后患者平衡能力及步行能力的影响

Effect of visual feedback balance training on balance and walking ability of patients after total knee arthroplasty

目的 探讨基于D-WALL系统的视觉反馈下平衡训练对全膝关节置换术(TKA)患者膝关节平衡功能及步行能力的影响。方法 选取60例TKA患者作为研究对象,按照随机数字表法分为视觉反馈组、常规平衡训练组和对照组,每组20例。对照组仅进行常规康复训练,视觉反馈组在对照组基础上增加视觉反馈下平衡训练,常规平衡训练组在对照组基础上进行常规平衡训练。治疗前和治疗6周后,使用D-WALL系统对3组患者进行平衡能力测试,并采用“起立—行走”计时测验(TUGT)评估3组患者步行能力。结果 治疗前,3组患者TUGT结果和睁眼、闭眼状态的运动轨迹面积、运动轨迹周长比较,差异均无统计学意义(P>0.05)。治疗6周后,3组患者睁眼、闭眼状态的运动轨迹面积、运动轨迹周长均小于治疗前,且视觉反馈组小于对照组、常规平衡训练组,差异有统计学意义(P<0.05)。治疗6周后,对照组、常规平衡训练组、视觉反馈组的TUGT结果依次为(14.1±1.9)、(11.7±2.5)、(9.6±2.0) s,分别短于治疗前的(17.2±3.0)、(15.8±3.6)、(16.9±4.4) s,且视觉反馈组短于对照组、常规平衡训练组,差异有统计学意义(P<0.05)。结论 基于D-WALL系统的视觉反馈下平衡训练可显著改善TKA患者的平衡能力,并提升独立步行能力,从而降低跌倒风险。

Objective To explore the effect of visual feedback balance training using a D-WALL system on balance of knee joint function and walking ability of patients with total knee arthroplasty(TKA). Methods Sixty patients with TKA were recruited as study objects, and were randomly divided into visual feedback group, conventional balance training group and control group, with 20 patients in each group. The control group only received routine rehabilitation training, the visual feedback group received balance training under visual feedback on the basis of the control group, and the conventional balance training group received routine balance training on the basis of the control group. Before treatment and 6 weeks after treatment, balance ability of three groups was tested using the D-WALL system, and their walking ability was assessed using the Timed Up and Go Test(TUGT). Results There were no statistical differences among the three groups in the movement track area and area movement track perimeter when opening and closing eyes, and TUGT results before treatment(P>0.05). After a six-week treatment, the movement track area and area movement track perimeter when opening and closing eyes were less than those before treatment, and the above indexes were lower in the visual feedback group than in the conventional balance training group and the control group,and the differences were statistically significant(P< 0. 05). The values of TUGT of control group,conventional balance training group and visual feedback group after 6 weeks of treatment were(14. 1 ± 1. 9),(11. 7 ± 2. 5),(9. 6 ± 2. 0) s, respectively, which were shorter than(17. 2 ±3. 0),(15. 8 ± 3. 6),(16. 9 ± 4. 4) s before treatment, and the value of TUGT was lower in thevisual feedback group than that in the conventional balance training group and the control group(P< 0. 05).Conclusion Visual feedback balance training based on the D-WALL system can sig-nificantly improve the balance ability of patients with TKA, increasingly promote independent walk-ing ability, thereby reducing the risk of falls.