反重力跑步机步行训练对半月板损伤术后患者足底压力的影响

Effect of anti-gravity treadmill walking training on plantar pressure distribution in postoperative patients with meniscus injury

目的 探究反重力跑步机步行训练对半月板损伤术后患者足底压力的影响。方法 招募膝关节半月板损伤术后患者40例,按照随机数表法分为常规治疗组和联合治疗组,每组各20例。常规治疗组进行常规康复治疗,联合治疗组在常规康复治疗的基础上增加反重力跑步机步行训练。治疗4周后,观察两组治疗前后Lysholm评分的变化;利用EMED足底压力分析设备对两组研究对象足底压力相关指标(最大受力、峰值压力、接触面积)进行分析和比较。结果 康复治疗后,两组Lysholm评分均较治疗前明显提高(P<0.05),且联合治疗组Lysholm评分亦优于常规组,差异有统计学意义(P<0.05)。最大受力比较结果显示,常规治疗组患侧后足、第1趾和第3~5趾最大受力均小于健侧,MH3、MH4的最大受力均大于健侧,联合治疗组患侧后足、MH1和第2趾区的最大受力均大于常规治疗组(P<0.05)。峰值压力比较结果显示,常规治疗组患者健侧的第1趾峰值压力大于联合治疗组;而组内患侧和健侧比较显示,常规治疗组患者患侧后足和第3~5趾的峰值压力小于健侧,患者患侧MH4的峰值压力大于健侧,联合治疗组患者患侧的后足和第1趾的峰值压力均小于健侧。接触面积比较显示,常规治疗组患者患侧的后足、MH1、第1趾和第3~5趾的接触面积均小于健侧。结论 常规康复联合反重力跑步机步行训练对膝半月板损伤术后的患者具有显著疗效,优于常规治疗方法,可以提高治疗后Lysholm评分,使其足底压力分布更接近正常状态,这为该类患者的康复治疗提供了新的思路。

Objective To explore the effect of anti-gravity treadmill walking training on the plantar pressure in patients with meniscus injury. Methods Forty postoperative patients with knee meniscus injury were randomly divided into two groups with 20 cases in each group: the control group received conventional rehabilitation treatment, while the study group received conventional rehabilitation and anti-gravity treadmill walking training. All patients were treated for 4 weeks. Lysholm scores were assessed before and after treatment in two groups;plantar pressure-related indicators(maximum force, peak pressure, contact area) were measured by EMED plantar pressure analyzing system and compared between two groups. Results The Lysholm scores after treatment were significantly higher than those before rehabilitation in both groups(P<0.05), and the scores of the study group were significantly higher than those of the control group(P<0.05). In control group the maximum forces on the hind foot, the first toe, and the third to fifth toes of the affected side were significant lower than those of the healthy side(P<0.05);and the maximum forces on the MH3 and MH4 of the affected side were greater than those of the healthy side. In study group the maximum forces on the hind foot, MH1 and the second toe area of the affected side were greater than those of the control group(P<0.05). The peak pressure of the first toe of unaffected side in the control group was higher than that of the study group(P<0.05). The peak pressure of the affected hind foot and the 3rd to 5th toes in the control group was lower than that of the unaffected side, while the peak pressure of MH4 of the affected side was greater than that of the unaffected side(P<0.05). In the study group the peak pressures of the hind foot and the first toe of the affected side were lower than those of the uninfected side(P<0.05). Patients in the control group showed smaller contact areas of hind foot, MH1, the first toe and the third to fifth toes than those of the healthy side(P<0.05). Conclusion Conventional rehabilitation combined with anti-gravity treadmill walking training demonstrates a better treatment effect than conventional treatment for patients with meniscus injury. It improves the knee function and makes the plantar pressure distribution closer to the normal state.