神经肌肉电刺激对三踝骨折术后踝关节功能的影响

Effect of neuromuscular electrical stimulation on ankle joint function after trimalleolar fracture

目的观察神经肌肉电刺激(neuromuscular electrical stimulation,NMES)对三踝骨折术后踝关节功能的影响。方法选取2022年1月至2022年12月在大连市第二人民医院手足踝一体化诊治中心进行手术治疗的三踝骨折患者30例,采用随机数表法分为研究组和对照组,每组各15例。研究组采用NMES治疗4周,对照组采用常规20磅弹力带抗阻训练治疗4周,两组患者平衡训练2周后做步态分析,比较两组患者的大腿周径差、美国足踝外科协会(American Orthopedic Ankle Foot Society and Ankle,AOFAS)踝与后足功能评分、足落地强度、动态平衡能力、步速以及跌倒风险。结果经过6周康复训练,两组患者的大腿周径差、AOFAS评分均具有显著差异(P<0.01),且研究组的大腿周径差、AOFAS评分改善程度显著优于对照组(P<0.01);研究组足落地强度(97.30,98.30)、动态平衡能力(91.00,92.60)、步速(99.00,100.00)评分均高于对照组[(81.50,84.20)、(85.30,86.20)、(65.80,67.00)],研究组跌倒风险(1.90%,1.93%)低于对照组(9.78%,10.40%),差异有统计学意义(P<0.05)。结论NMES对三踝骨折术后踝关节功能的影响优于常规弹力带抗阻训练。

Objective To investigate the effect of neuromuscular electrical stimulation(NMES)on ankle joint function after trimalleolar fracture.Methods From January 2022 to December 2022,30 patients with trimalleolar fracture who underwent surgical treatment in the integrated Diagnosis and treatment Center of the Second People’s Hospital of Dalian were selected and divided into study group and control group by random number table method,with 15 cases in each group.The study group was treated with NMES for 4 weeks,while the control group was treated with conventional 20-pound elastic band resistance training for 4 weeks.Gait analysis was performed after balance training for 2 weeks.Circumference difference of thigh,American Orthopedic Foot and Ankle Socity(AOFAS)ankle and hindfoot scores,foot strength,dynamic balance,walking speed,and fall risk were compared between the two groups.Results After 6 weeks of rehabilitation training,there were significant differences in thigh circumference difference and AOFAS score between the two groups(P<0.01),and the improvement degree of thigh circumference difference and AOFAS score in the study group was significantly better than that in the control group(P<0.01).The research group’s foot strength(97.30,98.30),dynamic balance ability(91.00,92.60),walking speed(99.00,100.00)scores were higher than those of the control group[(81.50,84.20),(85.30,86.20),(65.80,67.00)].The percentage of fall risk in the study group(1.90%,1.93%),was lower than that in the control group(9.78%,10.40%),and the differences were statistically significant(P<0.05).Conclusion NMES has the best effect on ankle joint function after trimalleolar fracture.