全膝关节置换术后早期床上单车运动联合反馈强化式健康教育对膝关节功能和生活能力影响的前瞻性研究

Influence of early bed cycling exercise combined with feedback-intensive health education after total knee arthroplasty on knee function and living ability

目的分析床上单车运动联合反馈强化式健康教育对全膝关节置换术(total knee arthroplasty,TKA)术后早期膝关节功能和生活能力的影响。方法本研究是前瞻性研究,选取2019年1月至2020年4月,在我院行TKA的患者150例为研究对象,遵循随机数字表法分组原则,分为观察组、对照组,每组例数为75例。对照组实施CPM被动运动训练方法及常规健康教育,观察组采用床上单车运动联合反馈强化式健康教育进行干预。比较两组患者疼痛数字评分法(numerical rating scale,NRS)评分、膝关节评分系统(the hospital for special surgery,HSS)评分、膝关节活动度(rang of motion,ROM)评分、基本生活能力量表(basic activities of daily living,BADL)评分、并发症情况和护理满意度。结果HSS评分:观察组(96.59±9.76),对照组(86.88±7.25);ROM评分:观察组(91.24±6.41),对照组(85.35±5.01);BADL评分:观察组(78.21±3.15),对照组(64.36±3.05);NRS评分:观察组(3.13±0.57),对照组(4.35±0.64),差异均有统计学意义(P<0.05)。观察组患者下肢静脉血栓和伤口疼痛发生率显著低于对照组,护理总满意度显著高于对照组(P<0.05)。结论早期床上单车运动联合反馈强化式健康教育可以减轻TKA患者疼痛感,促进膝关节功能恢复,提高患者日常生活能力和护理满意度。

Objective To analyze the effect of bed cycling combined with feedback-intensive health education on knee function and living ability in the early stage after total knee arthroplasty.Methods This study was a prospective study.A total of 150 patients who underwent total knee arthroplasty in our hospital from January 2019 to April 2020 were selected as the study subjects.Following the principle of random number table grouping,they were divided into observation group and control group,with 75 cases in each group.The control group was given CPM passive exercise training and routine health education,and the observation group had bed cycling combined with feedback-intensive health education.HSS,ROM,NRS and BADL scores were compared between the two groups.Results HSS score:observation group(96.59±9.76),control group(86.88±7.25);ROM:observation group(91.24±6.41),control group(85.35±5.01);BADL score:observation group(78.21±3.15),control group(64.36±3.05);NRS score:observation group(3.13±0.57),control group(4.35±0.64);differences were statistically significant(P<0.05).The incidences of lower extremity venous thrombosis and wound pain in the observation group were significantly lower than that in the control group,and the total satisfaction of nursing was significantly higher than that in the control group(P<0.05).Conclusions Cycling motion in bed combined with feedback-intensive health education can promote the recovery of knee function,reduce pain,and improve ability of daily living and nursing satisfaction.