移动康复APP对膝关节置换术后患者居家康复疗效影响的研究

Effectiveness of mobile rehabilitation App on home rehabilitation in patients after knee replacement surgery

目的探讨一款自主研发的移动康复应用软件(APP)对膝关节骨性关节炎(KOA)患者膝关节置换术(TKA)后居家康复疗效的影响。方法选取赣南医科大学第一附属医院骨科于2021年4月—2022年4月收治的43例已行TKA的KOA患者作为研究对象。采用随机数字表法将患者分为2组,其中对照组(21例)采用常规电话随访,试验组(22例)接受基于移动康复APP指导的康复治疗。分别在出院时、出院后2周及出院后8周对2组患者采用视觉疼痛模拟评分量表(VAS)、膝关节主动关节活动度(AROM)、膝关节协会评分(KSS)和西安大略和麦克马斯特大学骨关节炎指数(WOMAC)进行评估。结果43例患者无脱落情况,在出院后8周内均无并发症发生。分析2组患者不同时间点KSS临床评分、KSS功能评分、WOMAC评分、AROM、VAS评分的结果显示:时间效应均有统计学意义(P<0.05),这表明2组患者的KSS临床评分、KSS功能评分、WOMAC评分、AROM、VAS评分随时间而改变;2组患者KSS临床评分、KSS功能评分、WOMAC评分、AROM组间效应差异均有统计学意义(P<0.05),2组患者VAS评分组间效应差异无统计学意义(P>0.05);2组患者KSS临床评分、KSS功能评分、AROM、VAS评分交互效应无统计学意义(P>0.05),2组患者WOMAC评分交互效应具有统计学意义(P<0.05)。无论试验组和对照组,与出院时相比,患者出院后2周和出院后8周的WOMAC总分均有所下降(P<0.05)。此外,试验组与对照组在出院时WOMAC总分差异无统计学意义(P>0.05),在出院后2周和出院后8周时,2组患者的WOMAC总分差异均存在统计学意义(P<0.05)。结论移动康复APP指导下的居家康复有助于改善KOA患者TKA后的膝关节功能,改善患者日常生活活动能力。

Objective To investigate the impact of a self-developed mobile rehabilitation application(App)on the home rehabilitation efficacy of patients undergoing knee replacement surgery(TKA)for knee osteoarthritis(KOA).Methods A total of 43 KOA patients who underwent TKA from April 2021 to April 2022 were selected and randomly assigned to two groups:the control group(n=21)receiving conventional telephone follow-ups,and the experimental group(n=22)receiving rehabilitation guidance via the mobile app.Evaluations using the Visual Analogue Scale(VAS),Active Range of Motion(AROM),Knee Society Score(KSS),and Western Ontario and McMaster Universities Arthritis Index(WOMAC)were conducted at discharge,two weeks post-discharge,and eight weeks post-discharge.Results None of the 43 patients dropped out,and no complications occurred within 8 weeks post-discharge.The analysis of KSS clinical scores,KSS functional scores,WOMAC scores,AROM,and VAS scores at different time points revealed that the time effect was statistically significant(P<0.05),indicating changes over time in all measures for both groups.Group effects showed significant differences in KSS clinical scores,KSS functional scores,WOMAC scores,and AROM between groups(P<0.05),but no significant difference in VAS scores(P>0.05).Interaction effects were not statistically significant for KSS clinical scores,KSS functional scores,AROM,and VAS scores(P>0.05),but significant for WOMAC scores(P<0.05).For both experimental and control groups,WOMAC total scores significantly decreased at 2 weeks and 8 weeks post-discharge compared to discharge(P<0.05).There was no significant difference in WOMAC total scores between the groups at discharge(P>0.05),but significant differences were noted at 2 weeks and 8 weeks post-discharge(P<0.05).Conclusion Home rehabilitation guided by the mobile rehabilitation App helps improve knee joint function and activities of daily living in patients with KOA after TKA.