智能化膝关节康复仪联合渐进性肌肉放松训练对胫骨平台骨折术后患者膝关节功能的影响

Effects of intelligent knee rehabilitation instrument combined with progressive muscle relaxation training on knee joint function of postoperative patients with tibial plateau fracture

目的回顾性分析智能化膝关节康复仪联合渐进性肌肉放松训练(PMRT)对胫骨平台骨折术后患者疼痛及膝关节功能的影响。方法收集2021年1月至2023年8月南阳市第一人民医院西区医院收治的86例胫骨平台骨折患者病历资料,根据不同治疗方案将患者分为两组,其中行PMRT治疗的43例为对照组,行PMRT+智能化膝关节康复仪治疗的43例为联合组。对比两组康复指标、疼痛程度[视觉模拟评分法(VAS)评估]、肿胀程度、舒适度[Kolcaba简化舒适度量表(GCQ)评估]、下肢功能[下肢功能评定量表(LEFS)评估]、膝关节功能[美国特种外科医院膝关节评分(HSS)评估]与躯体活动能力[躯体生活自理量表(PSMS)评估]。结果联合组患肢肌肉舒缩活动恢复时间、镇痛药使用时间、骨折愈合时间分别为(20.30±3.43)h、(4.62±0.32)d、(14.52±1.80)周,短于对照组的(25.90±2.64)h、(6.34±0.76)d、(16.68±1.64)周,差异有统计学意义(P<0.05);干预2周、4周后联合组VAS评分、PSMS评分、肿胀程度分别为(2.79±0.46)分、(1.40±0.35)分、(13.05±1.50)分、(10.05±1.10)分、(3.05±0.52)cm、(2.16±0.28)cm,低于对照组的(3.25±0.53)分、(1.91±0.40)分、(14.54±2.07)分、(12.64±1.17)分、(3.66±0.65)cm、(3.25±0.53)cm,GCQ、LEFS、HSS评分分别为(65.32±3.90)分、(78.60±4.98)分、(38.98±4.05)分、(45.30±3.64)分、(30.63±2.51)分、(45.81±3.04)分,高于对照组的(63.08±4.12)分、(75.62±5.23)分、(35.63±3.82)分、(41.28±4.09)分、(28.90±2.04)分、(41.30±3.47)分,差异有统计学意义(P<0.05)。结论胫骨平台骨折术后使用智能化膝关节康复仪联合PMRT干预可缓解疼痛及肿胀,促进骨折愈合,改善下肢、膝关节功能及躯体自理生活能力。

Objective To retrospectively analyze the effects of intelligent knee rehabilitation instrument combined with progressive muscle relaxation training(PMRT)on pain and knee joint function of postoperative patients with tibial plateau fracture.Methods The medical records of 86 patients with tibial plateau fracture admitted to Nanyang First People's Hospital West Hospital from January 2021 to August 2023 were collected.According to different treatment plans,the patients were divided into two groups,among which 43 patients receiving PMRT treatment were included in the control group,and 43 patients receiving PMRT+intelligent knee rehabilitation instrument were included in the combined group.The two groups were compared with rehabilitation indicators,pain degree(visual analogue scale[VAS]assessment),swelling degree,comfort level(Kolcaba general comfort questionnaire[GCQ]assessment),lower limb function(lower extremity functional scale[LEFS]assessment),knee function(American Hospital for Special Surgery[HSS]knee joint score assessment)and physical activity ability(physical self-maintenance scale[PSMS]assessment).Results The recovery time of muscle contraction activity,analgesic use time and fracture healing time of the affected limb in the combined group were(20.30±3.43)h,(4.62±0.32)d and(14.52±1.80)weeks,respectively.It was shorter than the control group(25.90±2.64)h,(6.34±0.76)d,(16.68±1.64)weeks,and the difference was statistically significant(P<0.05).After 2 and 4 weeks of intervention,VAS,PSMS score and swelling degree of the combined group were(2.79±0.46)points,(1.40±0.35)points,(13.05±1.50)points,(10.05±1.10)points,(3.05±0.52)cm and(2.16±0.28)cm,respectively,lower than the control group(3.25±0.53),(1.91±0.40)points,(14.54±2.07),(12.64±1.17),(3.66±0.65)cm,and(3.25±0.53)cm.The scores of GCQ,LEFS and HSS were(65.32±3.90),(78.60±4.98),(38.98±4.05),(45.30±3.64),(30.63±2.51)and(45.81±3.04),respectively,higher than those of the control group(63.08±4.12),(75.62±5.23),(35.63±3.82),(41.28±4.09),(28.90±2.04),and(41.30±3.47),with difference of statistical significance(P<0.05).Conclusion For postoperative patients with tibial plateau fracture,the use of intelligent knee rehabilitation instrument combined with PMRT intervention can relieve pain and swelling,promote fracture healing,improve the function of lower limbs and knee joints and the self-care ability.