神经肌肉训练对膝关节半月板损伤患者术后功能恢复的临床效果及预后影响因素分析

Clinical effect of neuromuscular training on functional recovery of patients with knee meniscus injury and analysis of prognostic influencing factors

目的 探讨神经肌肉训练用于膝关节半月板损伤术后患者功能恢复的临床效果及其预后影响因素分析。方法 选取2017年10月至2021年8月上海交通大学医学院附属瑞金医院舟山分院收治的膝关节半月板损伤患者192例作为研究对象,采用数字表法随机分为两组,每组各96例。所有患者均行关节镜检查,行半月板成形术治疗后,对照组采用常规康复训练,观察组采用神经肌肉训练。治疗后,根据膝关节功能和Lyscholm评分进行疗效评价,治疗前后采用感觉阈值测量法对被动60°位置觉、60°运动觉和等张功率(伸、屈)进行测定。记录患者相关临床资料,采用单因素分析和Logistic回归分析影响患者预后的相关因素。结果 治疗后,两组优良率、被动60°位置觉、60°运动觉、等张功率(伸)、等张功率(屈)相比,差异有统计学意义(P<0.05)。单因素分析和多因素Logistic回归分析表明,年龄、体质量指数、关节软骨损伤、病程、损伤部位、术后肢体冷敷、术后开始负重时间均为膝关节半月板损伤患者术后预后的独立影响因素(P<0.05)。结论 神经肌肉训练助于提高膝关节半月板损伤患者的术后疗效,有效促进患者被动位置觉、运动觉和肌肉等张力量的恢复。患者预后情况与年龄、体质量指数、关节软骨损伤、病程、损伤部位、术后肢体冷敷、术后开始负重时间有关。

Objective To explore the clinical effect and prognostic influencing factors of neuromuscular training for functional recovery of patients with knee meniscus injury.Methods A total of 192 patients with knee meniscus injury treated in Zhoushan Branch Shanghai Ruijun Hospital from October 2017 to August 2021 were randomly divided into two groups,with 96 cases in each group.All patients underwent arthroscopy,after meniscus plasty treatment,control group patients received conventional rehabilitation training,and observation group patients received neuromuscular training.After treatment,the curative effect was evaluated according to the function of the knee joint and the Lyscholm score.Before and after treatment,the sensory threshold measurement method was used to measure passive 60°position sensation,60°kinesthesia and isotonic power(extension and flexion).The relevant clinical data of the patients were recorded,and use single factor analysis and multiple logistic regression model to analyze the relevant factors that affect the prognosis of the patients.Results After treatment,there were significant differences in the excellent and good rate,passive 60°position sense,60°kinematic sense,isotonic power(extension)and isotonic power(flexion)between the two groups(P<0.05).Univariate analysis and multivariate Logistic analysis showed that age,body mass index,articular cartilage injury,course of disease,injury site,postoperative cold compress of limbs,and time to load after operation were the independent factors influencing the prognosis of patients with knee meniscus injury after operation(P<0.05).Conclusion Neuromuscular training can help improve the postoperative curative effect of patients,and can effectively promote the recovery of passive position sense,kinesthesia and muscle isotonic strength of patients,and it is worthy of promotion.The prognosis of patients is related to age,body mass index,articular cartilage injury,disease course,injury site,postoperative cold compress of limbs and time to start weight bearing after operation.