体外冲击波疗法联合下肢肌力训练对关节镜下前交叉韧带重建术后患者关节稳定性活动度及平衡功能的影响

Effects of Extracorporeal Shock Wave Therapy Combined with Lower Limb Muscle Strength Training on Joint Stability Range of Motion and Balance Function in Patients after Arthroscopic Anterior Cruciate Ligament Reconstruction

目的:探讨体外冲击波疗法(extracorporeal shock wave therapy,ESWT)联合下肢肌力训练对关节镜下前交叉韧带重建术(Anterior Cruciate Ligament Reconstruction,ACLR)后患者关节稳定性、活动度(range of motion,ROM)及平衡功能的影响。方法:选取2020年1月至2021年9月期间联勤保障部队983医院收治的92例关节镜下ACLR术后患者为研究对象,随机分为观察组(n=46)与对照组(n=46),对照组予常规术后下肢肌力训练,观察组患者在上述基础上加用ESWT,持续5周。比较两组患者干预前、干预后10周的患侧与健侧胫骨后向前移动距离的差值(以下简称“胫骨前移差”)、膝关节ROM、国际膝关节文献委员会(international knee documentation committee,IKDC)膝关节功能评分及Berg平衡量表(Berg Balance Scale,BBS)。结果:组内比较,两组患者干预后的胫骨前移差低于干预前,膝关节ROM、IKDC及BBS评分高于干预前(P<0.05)。组间比较,观察组患者干预后的胫骨前移差值低于同期对照组,膝关节ROM、IKDC及BBS评分及干预前后各指标的差值高于对照组(P<0.05)。结论:ESWT联合下肢肌力训练能显著改善关节镜下ACLR术后患者的膝关节稳定性、ROM及平衡功能,值得临床推广应用。

Objective:To investigate the effect of extracorporeal shock wave therapy(ESWT)combined with lower limb muscle strength training on joint stability,range of motion(ROM)and balance function of patients after arthroscopic anterior cruciate ligament reconstruction(ACLR).Methods:92 post-arthroscopic ACLR patients admitted to Hospital 983 of the Joint Security Force between January 2020 and September 2021 were selected for the study and randomly divided into the observation group(n=46)and the control group(n=46),the control group was given conventional post-operative lower limb muscle strength training,and the patients in the observation group were given ESWT on top of the above for 5 weeks.The difference in the distance of posterior anterior tibial movement between the affected side and the healthy side before and 10 weeks after the intervention(hereinafter referred to as"tibial anterior displacement difference"),the knee ROM,the knee function score of the international knee documentation committee(IKDC)and the Berg Balance Scale(BBS)were compared between the two groups.Results:In the intra-group comparison,patients in both groups had lower tibial anterior displacement difference after the intervention than before the intervention,and higher knee ROM,IKDC and BBS scores than before the intervention(P<0.05).For comparison between groups,the difference in tibial anterior displacement of patients in the observation group after intervention was lower than that of the control group during the same period,and the difference in knee ROM,IKDC and BBS scores and each index before and after intervention was higher than that of the control group(P<0.05).Conclusion:ESWT combined with lower limb muscle strength training could significantly improve the knee joint stability,ROM and balance function of patients after arthroscopic ACLR,which is worthy of clinical application.