Optimizing Recovery Following Mihata Superior Capsular Reconstruction Surgery with Tensor Fascia Lata Auto Graft: A Comprehensive Rehabilitation Protocol

Objective: Superior Capsular Reconstruction (SCR) using a Tensor Fascia Lata (TFL) autograft is an evolving technique for treating irreparable rotator cuff tears. The Mihata technique, initially developed in Japan, has shown promising long-term results. However, a standardized post-operative rehabilitation protocol for this procedure in the USA is lacking. Purpose: This study aims to evaluate the outcomes of a comprehensive rehabilitation protocol following SCR with TFL autograft in a cohort of nine patients. Participants and Methods: A prospective observational study was conducted at Concentra Urgent Care, San Francisco. Nine patients, aged 55 - 65 years, underwent SCR with TFL autograft performed by a specialized orthopedic surgeon. Post-operative rehabilitation was managed using a structured protocol, divided into three phases focusing on passive exercises, progressive range of motion, and strengthening. Outcomes were measured using the Visual Analogue Scale (VAS) for pain, forward flexion range of motion (FF-ROM), and Single Assessment Numeric Evaluation (SANE) scores over a six-month period. Results: Significant improvements were observed in pain reduction (mean VAS decrease of −3.67 points, p = 0.01), ROM (mean FF increase of 41.11 degrees, p = 0.014), and SANE scores (mean improvement of 42.11%, p = 0.009), indicating the efficacy of the rehabilitation protocol. Conclusion: The comprehensive rehabilitation protocol following SCR with TFL autograft significantly improved pain, range of motion, and shoulder function in patients, suggesting its potential utility in clinical practice.

Reviews on Post-earthquake Reconstruction of Qiang Culture: Three-dimensional Pattern

Through the introduction of disaster situation of Qiang Culture after Wenchuan Earthquake, the paper emphasized that carriers of Qiang Culture had been seriously damaged, the inheritance of Qiang Culture had been affected, and the environment for Qiang Culture was difficult to recover. It highlighted that three-dimensional reconstruction of Qiang Culture should stress the core task and timely and effectively rescue endangered cultural heritages of Qiang Nationality from the perspectives of material and spiritual life. It had explained focuses of three-dimensional pattern construction in detail. In terms of spatial reconstruction, it should reconstruct native culture and history while material culture was constructed, and reconstruct Qiang culture highland by depending on aborigines; in terms of cluster reconstruction, it should give support to large tourism enterprises and perfect tourism chain; in terms of ecological reconstruction, it should enhance construction and demonstration of "ecological protection pilot area of Qiang culture"; in terms of development reconstruction, it should realize coordinated unity between protection and development according to classification protection, characteristic protection and key protection, so as to form the virtuous circle of post-disaster recovery protection and sustainable development.

Analysis of therapeutic effect of rehabilitation treatment improving function of knee joint following reconstruction anterior crucial ligament with allogenic achilles tendon under arthroscopy

Objective Combining the reconstruction of anterior crucial ligament(ACL) with functional rehabilitation,we recover the injured knee as possible as can.Methods 38 patients received ACL reconstruction with allogenci Achilles tendon under arthroscopy.We reconstructed the injured ACL and the injured medial crucial ligament(MCL) by utilization of length of achiles tendon.Then we carried out different rehabilitations in accordance with special needs of the patients.Results The follow up was performed for more than 7 months in 34 cases.Lysholm method was used to evaluate patients’ function before and after operation.Results showed average score was 53.8 preoperatively, and 84.2 postoperatively,the good rate was 84.4%.In the objective examination,anterior drawer test(ADT),31 cases were positive preoperatively,1 was positive postoperatively;lachman test:34 were positive preoperatively,1 was positive postoperatively;4 were weak positive postoperatively.There were 3 cases with pain of knee joints and 4 cases with limitation of activity of knee joints(5～20 degree) postopratively.Conclusion Combination of reconsgruction of ACL with allogenic achilles tendon and the functional rehabilitation can gain remarkable curative effect.

Problem identification and revitalization strategies for the recovery and reconstruction of traditional villages in the Ms 6.8 Luding Earthquake

Post-disaster reconstruction is a topic of global concern,and traditional villages have special heritage attributes and need to face more requirements and obstacles in post-disaster reconstruction.This paper summarizes four concepts based on the research on post-disaster reconstruction both domestically and internationally,as well as the recovery and reconstruction of cultural heritage.Through a field survey of traditional villages in the Ms 6.8 Luding earthquake-stricken area,it is found that there are problems such as insufficient awareness of heritage value,misalignment of scientific reconstruction technology,and insufficient protection of reconstruction elements during the reconstruction process.Traditional villages face the risk of declining or even loss of heritage value.In order to effectively protect traditional villages and inherit the carrier of regional culture,four targeted reconstruction response strategies are proposed,i.e.,to"establish special planning for traditional village preservation","emphasize recovery of the authenticity of village heritage","ensure elements for village heritage recovery"and"promote the activation and utilization of village heritage",based on the problems discovered during the survey and the four concepts summarized in the research on post-disaster reconstruction of traditional villages.The research results hope to provide useful reference for ancient cultural areas affected by earthquakes on how to protect cultural heritage during the post-disaster reconstruction process.

Effect of suspension training on neuromuscular function, postural control, and knee kinematics in anterior cruciate ligament reconstruction patients

BACKGROUND Suspension training(SET)is a method of neuromuscular training that enables the body to carry out active training under unstable support through a suspension therapy system.However,there have been few reports in the literature on the application of SET to anterior cruciate ligament reconstruction(ACLR)patients.It is not clear what aspects of the patient's function are improved after SET.AIM To investigate the effect of SET on the neuromuscular function,postural control,and knee kinematics of patients after ACLR surgery.METHODS Forty participants were randomized to an SET group or a control group.The SET group subjects participated in a SET protocol over 6 wk.The control group subjects participated in a traditional training protocol over 6 wk.Isokinetic muscle strength of the quadriceps and hamstrings,static and dynamic posture stability test,and relative translation of the injured knee were assessed before and after training.RESULTS The relative peak torque of the quadriceps and hamstrings in both groups increased significantly(P<0.001),and the SET group increased by a higher percentage than those in the control group(quadriceps:P=0.004;hamstrings:P=0.011).After training,both groups showed significant improvements in static and dynamic posture stability(P<0.01),and the SET group had a greater change than the control group(P<0.05).No significant improvement on the relative translation of the injured knee was observed after training in either group(P>0.05).CONCLUSION Our findings show that SET promotes great responses in quadriceps and hamstring muscle strength and balance function in ACLR patients.

Developing an enhanced recovery after surgery program for oncology patients who undergo hip or knee reconstruction surgery

Enhanced recovery after surgery(ERAS)protocols are applied in orthopedic surgery and are intended to reduce perioperative stress by implementing combined evidence-based practices with the cooperation of various health professionals as an interdisciplinary team.ERAS pathways include pre-operative patient counselling,regional anesthesia and analgesia techniques,post-operative pain management,early mobilization and early feeding.Studies have shown improvement in the recovery of patients who followed an ERAS program after hip or knee arthroplasty,compared with those who followed a traditional care approach.ERAS protocols reduce post-operative stress,contribute to rapid recovery,shorten length of stay(LOS)without increasing the complications or readmissions,improve patient satisfaction and decrease the hospital costs.We suggest that the ERAS pathway could reduce the LOS in hospital for patients undergoing total hip replacement or total knee replacement.These programs require good organization and handling by the multidisciplinary team.ERAS programs increase patient's satisfaction due to their active participation which they experience as personalized treatment.The aim of the study was to develop an ERAS protocol for oncology patients who undergo bone reconstruction surgeries using massive endoprosthesis,with a view to improving the surgical outcomes.

Relative Impact of Oral Rehabilitation on Quality of Life and Patient Satisfaction Following Mandibular Resection in a Sub-Urban Nigerian Tertiary Hospital

Background: Resection of the mandible can lead to bony defect which has a direct bearing on the quality of life of the patient. Reconstruction of such defect is necessary to restore aesthetics but optimal functioning of the oral cavity can only be achieved with prosthodontic rehabilitation. We, hereby, report the impact of oral rehabilitation on patients’ satisfaction and quality of life after mandibular reconstruction in our institution. Materials and Method: Patients who had oral rehabilitation following mandibular reconstruction from January 2010 to December 2015 were included. Patients’ oral health related quality of life [OHRQL] before and after rehabilitation was evaluated using the head and neck module of the European Organization for Research and Treatment of Cancer [EORTC]. Oral functions and denture satisfaction were also evaluated with Visual Analogue Scale [VAS]. Data obtained were analyzed with SPSS version 20 and level of significance was set at p Result: Of the 43 patients who had mandibular reconstruction during the study period, only 21 [48.8%] had dental rehabilitation. Twelve patients [57.1%] had conventional acrylic denture, 5 had fixed denture [bridge] while 4 patients had rehabilitation with dental implants. The mean follow-up period after rehabilitation was 8.42 months [Range: 6 - 22 months]. Although, OHRQL analysis revealed an improvement following rehabilitation, only the social aspect of the evaluation was statistically significant [p p = 0.00]. On the contrary, there was no statistically significant difference in aesthetics amongst the patients regardless of type of rehabilitation [p = 0.26]. Conclusion: Findings from this study showed that there is improvement in OHRQL following dental rehabilitation. Also, Patients who were rehabilitated with dental implant had better oral function than those with fixed or conventional denture.

Implantosuported Rehabilitation after Marginal Recession of Mandibular Calcifying Epithelial Odontogenic Tumor: Case Report

The Calcifying Epithelial Odontogenic Tumor (CEOT) also called the Pindborg’s Tumor represents a rare benign epithelial odontogenic neoplasm with locally aggressive behavior. Surgical excision with a safety margin is one of the treatment options, requiring bone and soft tissue reconstruction for implant-supported rehabilitation, providing the individual with a return to adequate oral functions. The objective of the present study is to report on the case of the treatment stages and the factors involved in the rehabilitation of a 23-year-old man with a history of mandibular lesion diagnosed as CEOT. A marginal resection of the mandible lesion was performed, with posterior reconstruction with iliac crest bone graft and soft tissue graft to allow the implant-supported rehabilitation. Currently, in the postoperative control, the individual shows no signs of tumor recurrence and is rehabilitated without functional and/or aesthetic complaints. Surgical excision should be framed as a form of treatment, aiming for better resolution in the more complex cases of these invasive tumors.

Complication of lengthening and the role of post-operative care, physical and psychological rehabilitation among fibula hemimelia

There is a clear clinical need for efficient physiotherapy and rehabilitation programs during and after bone lengthening and reconstruction for gaining the optimal effect and also prevention or treatment of lengthening side effects.Pin tract infection is the most prevalent side effect during lengthening which could be prevented and treated initially via proper wound care.Muscle contractures are typically a consequence of the generated tension on the distracted muscle.It can be managed by physiotherapy initially and surgically in later severe stages.Furthermore,it is essential to avoid muscle contracture development,which is the demonstration of the imbalanced muscle appeals on the joint to inhibit the following subluxation.The knee is the furthermost affected joint by the aforementioned problem due to the inherent lack of ligamentous and bony stability.Joint stiffness is the other possible unfavorable effect of lengthening.It happens because of extensive muscle contractures or may possibly be attributed to rigidity of the joint following the amplified pressure on the joint surface during the process of lengthening.Physiotherapy and occupational therapy including endurance and strength exercise as well as stretching play an important role during the rehabilitation periods for the prevention and also the treatment of muscle contracture and the following deformity and also joint stiffness.Likewise,the effect of mental and physical rehabilitation programs should not be overlooked.

Major Issues of Post-earthquake Housing Construction during Resettlement

Natural disasters provide an acute image of how man-made technologies are a cause of conflict when it comes to nature. It is man versus wild in its true means. The nature lets us grow and increase our settlements. We encroach on other animals＇ territories and it is only when the environment＇s patience runs out that it retaliates in forms of natural disasters. These disasters affect numerous lives and kill a lot ofhnmans. This is the main reason why we require more stable structures and preventive measures to battle the wrath of the nature. Rescue and search operations are conducted by many different government and private agencies including NGOs. These operations aim at providing the required relief and supplies after the disaster. Injured people need to be treated. People in dangerous zones need to be evacuated. Help is needed in many forms. Out of the many natural disasters, this paper will focus on the occurrence of earthquakes. Severe earthquakes destroy buildings and structures like roads, bridges etc. and wreak havoc in the community. Earthquakes largely damage all human constructions, including houses. This is the reason why a reconstruction program for dwellings and housings is of utmost importance. A home is only secondary to basic needs such as food and water. A well-planned strategy is important when it comes to launching a post-earthquake reconstruction program. The strategy should be reasonable and should consider the best interests of everyone affected; self-help and imported fabrication should play no part in the decision-making procedures. Creating awareness, physically demonstrating options and delivering are the three steps for the success of reconstruction programs. The extent of affected area and the magnitude of earthquakes are variable in nature and it is on these two aspects that the reconstruction strategy is devised. Technical aspects are focused towards the development of the affected areas and conceptual design of surrounding neighborhoods. It also aims at identifying seminars and programs based on easy financing for a new home. Along with these, review processes are conducted for the analysis of new residential needs based on optimizing the use of available land for planning and development. The paper discusses the construction of housing and resettlements as prioritized activities that must be undertaken post an earthquake. Earthquakes physically only destroy structures and buildings but for the people affected, they destroy lives, jobs, companies, sources of food and the sense of safety and traumatize the ones who come out alive.

Cancer Rehabilitation,A New Discipline Based upon Multidisciplinary Collaboration

Cancer Rehabilitation is a new discipline,a combination of tumor medication,immunology,psychology,nutritional science and exercise physiology etc..The core of cancer rehabilitation is the therapy of natural immunology,which aims at activating T-cells,and restoring the bone marrow function impaired during chemo-radiation therapy.Cancer rehabilitation seeks to achieve the gradual recovery of the immune system,which in turn hinders recurrence and metastasis.In addition,with the help of psychological consultation,nutritional and physical exercise guidance,cancer patients may have a better chance at managing the risk of recurrence and metastasis,extending life expectancy with an improved quality of life.

Land suitability assessment for post-earthquake reconstruction: A case study of Lushan in Sichuan, China

Land suitability assessment （LSA） is one of the key processes of land-use planning. Given its particularity of land suitability assessment for post-earthquake reconstruction, this paper takes into account geological conditions, risk of disasters, water and land resources conditions, and eco-environmental suitability and emphasizes safety factor in the assessment. Taking the April 20, 2013 Mw 6.6 Lushan earthquake as a case, this assessment establishes factors system, uses GIS spatial analysis techniques and data of geology, topography, resources, and eco-environment to evaluate the land suitability for reconstruction. The results show that： （1） the spatial characteristics of land suitability for reconstruction at grid scale and administrative scale manifest that most of the piedmont plains in the east are suitable for large-scale population aggregation, industrialization, and urbanization development; and （2） for the six hard-hit counties, Mingshan is the preferred region for large-scale post-earthquake reconstruction due to its high construction index and suitable land per capita, and some plots of land in the valleys could be selected for in-situ small-scale reconstruction in Lushan. The land suitability assessment for post-earthquake reconstruction would be significant to making sound reconstruction planning for achieving sustainable regional development in the Mw 6.6 Lushan earthquake stricken area. This study could be used as a reference for the regions with similar events.

前交叉韧带重建术后侧切动作的生物力学特征

目的:探究前交叉韧带(anterior cruciate ligament, ACL)重建术后12个月左右的患者在侧切动作过程中的生物力学特征,确定主要的异常生物力学特征及其机制。方法:对16例ACL重建术后12个月左右的患者同步采集侧切动作过程中的运动学和动力学参数,计算膝关节的三维角度和三维力矩。应用配对t检验方法分析重建侧与未伤侧之间的生物力学特征差异。结果:在侧切动作过程中,ACL重建侧的水平向后地面反作用力峰值(ACL重建侧0.380±0.071,未伤侧0.427±0.069,P=0.003)和垂直向上地面反作用力峰值(ACL重建侧1.996±0.202,未伤侧2.110±0.182,P=0.001)均显著小于未伤侧。与未伤侧相比,重建侧的膝关节屈曲角度较小(ACL重建侧38.3°±7.4°,未伤侧42.8°±7.9°,P<0.001),而外旋角度较大(ACL重建侧10.3°±2.4°,未伤侧7.7°±2.1°,P=0.008)。ACL重建侧的膝关节伸展力矩峰值(ACL重建侧0.092±0.031,未伤侧0.133±0.024,P<0.001)和外旋力矩峰值(ACL重建侧0.005±0.004,未伤侧0.008±0.004,P=0.015)均显著小于未伤侧。结论:在侧切动作过程中,ACL重建患者膝关节运动主要在矢状面和水平面内呈现不对称特征,重建侧呈现较小的屈膝角度、膝关节伸展力矩和外旋力矩和较大的膝关节外旋角度。

护士主导的医护技联合康复模式在前交叉韧带重建术病人中的应用

目的探讨护士主导的医护技联合康复模式对前交叉韧带重建术(ACLR)后病人功能恢复和重返运动的影响。方法按照病人入院的先后顺序,将我院骨科2021年1月至6月收治的50例病人纳入对照组,进行常规治疗护理和康复指导;2021年7月至2022年1月收治的50例病人纳入观察组,在常规治疗护理的基础上进行以护士主导的医护技联合康复。观察两组病人术后1~3 d、6个月和12个月数字评分法(NRS)的静、动态疼痛得分,术后首次下床活动时间,术后6个月和12个月国际膝关节文献委员会(IKDC)膝关节主观评分和Lysholm膝关节评分,以及术后重返运动和异常体征情况。结果干预后,观察组术后1~3 d的动、静态NRS疼痛得分和术后6个月的动态NRS疼痛得分显著低于对照组(P<0.05),术后首次下床活动时间早于对照组(P<0.05),术后6个月和12个月IKDC膝关节主观得分和Lysholm膝关节得分均显著高于对照组(P<0.05)。术后1年,观察组关节不稳的发生率明显低于对照组(8.51%vs.25.00%,P=0.032),重返运动率高于对照组(25.53%vs.12.50%,P=0.105)。结论护士主导的医护技联合康复模式可降低ACLR病人术后疼痛,促进病人早期下床活动,减少关节不稳的发生,提高膝关节功能的恢复,但在提高重返运动率方面还需要进一步的远程支持。

复元活血汤结合康复训练对膝关节前交叉韧带重建术膝关节疼痛和膝关节功能的影响

目的探究复元活血汤结合康复训练在行膝关节前交叉韧带重建术患者中的干预价值。方法选择本院2022年1月-2024年3月收治的136例接受膝关节前交叉韧带重建术的患者作为本次研究对象,严格按照随机数字表法分为两组,对照组接受常规康复治疗,研究组接受复元活血汤结合康复训练,各组均68例,均连续干预,对比两组疼痛情况[应用视觉模拟评分法(VAS)评价]、膝关节功能(使用Lysholm膝关节评分评价)、关节情况(如关节肿胀程度与膝关节活动度)与生活质量[运用生活质量调查问卷量表(SF-36)评价]。结果手术前,两组VAS评分、Lysholm膝关节评分差异无统计学意义(P>0.05),手术后1周与出院时,VAS评分均下降且研究组均低于对照组;Lysholm膝关节评分均升高,且研究组较对照组高(P<0.05)。研究组关节肿胀程度在数值上小于对照组,膝关节活动度高于对照组(P<0.05)。手术前、后比较,两组生活质量各维度评分均升高,且研究组高于对照组(P<0.05)。结论将复元活血汤结合康复训练应用在行膝关节前交叉韧带重建术患者中可缓解其疼痛、改善其膝关节功能,改善关节肿胀程度、提高膝关节活动度、提升生活质量,值得在临床上推广使用。

“开通玄府、养血柔筋”中药结合MTT医学训练式治疗对前交叉韧带重建术后康复疗效观察

目的:分析在前交叉韧带重建术后应用“开通玄府、养血柔筋”中药结合MTT医学训练式治疗的疗效。方法:纳入2021年1月~2023年6月漳州市中医院骨伤科收治的180例接受前交叉韧带重建术治疗的患者作为研究对象,应用随机数字表法分为对照组、MTT组和试验组各60例,分别行传统康复治疗、MTT医学训练式治疗和MTT医学训练式治疗+“开通玄府、养血柔筋”中药,比较三组康复治疗前后疼痛情况、膝关节主动关节活动度和肌肉力量情况、Tegner Lysholm膝关节评分。结果:康复治疗2周、4周、8周和16周后,三组疼痛VAS评分差异有统计学意义(P<0.05),其中试验组最低,其次为MTT组,对照组最高;三组膝关节主动关节活动度差异具有统计学意义(P<0.05),其中试验组最大,其次为MTT组,对照组最小。康复治疗16周后,三组慢速测试和快速测试两个模式下的膝关节屈伸肌峰力矩、平均功率、总功、主动肌与拮抗肌峰力矩比值差异有统计学意义(P<0.05),其中试验组慢速测试和快速测试两个模式下的膝关节屈伸肌峰力矩、平均功率和总功最大,其次为MTT组,对照组最小;试验组慢速测试和快速测试两个模式下的主动肌与拮抗肌峰力矩比值最小,其次为MTT组,对照组最大;三组Tegner Lysholm膝关节评分差异有统计学意义(P<0.05),其中试验组最高,其次为MTT组,最低为对照组。结论:“开通玄府、养血柔筋”中药结合MTT医学训练式治疗对前交叉韧带重建术后康复疗效提升明显,可更好地缓解患者疼痛症状,促进其膝关节主动关节活动度和肌肉力量的恢复。

移植物类型对前交叉韧带重建后患者膝关节功能的影响

背景:临床上常采用移植物重建前交叉韧带,而不同移植物类型又影响着患者术后膝关节功能和康复方案的制定。目的:回顾分析不同移植物类型对前交叉韧带重建后患者肌力、关节稳定性、功能性活动及重返运动的影响。方法:在PubMed、Web of Science、Cochrane、中国知网、万方数据库中进行检索,中文检索词为“前交叉韧带重建术,自体移植物,同种异体移植物,人工韧带,骨-髌腱-骨,股四头肌肌腱,腘绳肌肌腱,腓骨长肌肌腱,康复训练,重返运动”;英文检索词为“anterior cruciate ligament reconstruction,autografts,allografts,artificial ligaments,bone-patellatendon-bone,quadriceps tendon autograft,hamstring tendon autograft,peroneus longus tendon autograft,rehabilitation,exercise,protocol,return to sport”。结果与结论:选用骨-髌腱-骨移植物的患者应加强股四头肌离心收缩练习,康复后期应关注股四头肌耐力和爆发力的恢复。与骨-髌腱-骨移植物和腘绳肌肌腱移植物相比,选用股四头肌肌腱移植物的患者在5-8个月内符合回归标准的患者明显更少,应制定较长时间的训练计划,训练周期尽量持续到3年以上。选用腘绳肌肌腱移植物应强化多角度下腘绳肌力量训练,尤其是屈膝60°以上的周期至少持续至术后18周。选用腓骨长肌肌腱移植物的患者后续应加强踝关节周围肌肉力量,以足底肌肉力量为主。选用同种异体移植物应注意移植物经低剂量辐射消毒后其抗张力性降低20%,因此应关注膝关节稳定性训练。选用人工韧带移植物的患者3-6周内可渐进性增强股四头肌和腘绳肌力量训练,重视早期本体感觉练习,对平衡、跳跃及灵活性进行针对性训练。

基于快速康复外科理论的多维度康复护理对乳腺癌乳房再造术患者术后的恢复效果影响

目的分析基于快速康复外科理论的多维度康复护理对乳腺癌乳房再造术患者术后的恢复效果的影响。方法选取我院2022年4月至2023年4月收治的80例乳腺癌乳房再造术患者,采用随机数字表法分为对照组和试验组,每组40例,对照组采用常规康复护理干预,试验组采用基于快速康复外科理论的多维度康复护理,对比两组乳腺癌乳房再造术患者恢复效果心理危机水平和家庭功能、自我效能评分以及睡眠质量水平改善情况、并发症发生率。结果试验组外形、外观、手感等恢复效果评分均高于对照组(P<0.05)。两组乳腺癌乳房再造术患者护理前情感、行为、认知等心理危机水平和家庭功能、自我效能评分以及睡眠质量相比,差异无统计学意义(P>0.05);护理后两组情感、行为、认知等心理危机水平和家庭功能、自我效能评分以及睡眠质量均比护理前改善(P<0.05),且试验组乳腺癌乳房再造术患者情感、行为、认知等心理危机水平和家庭功能、自我效能评分以及睡眠质量改善程度比对照组更优(P<0.05)。试验组乳头挛缩、愈合不良、局部疼痛、皮下血肿等并发症发生率低于对照组(P<0.05)。结论基于快速康复外科理论的多维度康复护理对乳腺癌乳房再造术患者术后的恢复效果提升具有积极的影响,有利于改善患者的不良心理,提高患者自我效能、家庭功能以及睡眠质量。

血流限制训练对前交叉韧带重建患者膝关节功能恢复的Meta分析

目的:系统评价血流限制训练对前交叉韧带重建术后康复的临床疗效,以期为临床实践提供参考依据。方法:计算机检索中国知网、万方数据库、PubMed、Web of Science、EBSCO等数据库,搜集国内外有关血流限制训练干预前交叉韧带重建术后康复的随机对照试验,检索时限均从各数据库建库至2022-08-10。结局指标包括膝关节肌力、膝关节周围肌肉量及膝关节功能评价,均为连续性变量。由2名研究者独立筛选文献、提取资料并使用PEDro量表、Cochrane风险偏倚评估工具进行纳入研究的偏倚风险评价,然后采用RevMan5.4软件进行Meta分析。结果:共纳入9篇文献,包括226例受试者,其中试验组114例,对照组112例。Meta分析结果显示,血流限制训练组与常规抗阻训练组相比,可以显著改善患者膝关节肌力[SMD=0.54,95%CI(0.29,0.79),P<0.01]、肌肉量[SMD=0.26,95%CI(0.06,0.46),P=0.01]及膝关节功能[SMD=1.17,95%CI(0.53,1.80),P<0.01];亚组分析显示,仅当干预时间>4周时,膝关节肌力[SMD=0.68,95%CI(0.38,0.97),P<0.01]与肌肉量[SMD=0.38,95%CI(0.09,0.68),P=0.01]出现显著性改善。结论:当前的证据表明,血流限制训练可以改善前交叉韧带重建术后患者肌力及膝关节功能,减少肌肉萎缩,并建议术后干预时间达到4周以上以获得更好的肌力与肌肉量改善效果。

前交叉韧带重建术后不同时间介入康复治疗对膝关节功能恢复的影响

目的:探讨前交叉韧带(ACL)重建术后不同时间介入康复治疗对患侧膝关节功能恢复的影响。方法:回顾性分析2018年9月—2022年8月在徐州市中心医院骨科接受自体腘绳肌腱单束重建术及术后康复的96例ACL断裂患者的临床资料,共有54例患者在出院后3个月返回门诊随访并接受了康复评定,根据ACL重建术后介入康复治疗时间的不同分为早康复组(24例)和晚康复组(30例),早康复组在术后≤4周开始康复治疗;晚康复组在术后>4周开始康复治疗。收集患者入院时的一般资料,并对患者入院时、出院时及随访时的膝关节主动屈、伸活动度评定,视觉模拟量表(VAS)评分及国际膝关节文献委员会主观膝关节评分(IKDC)进行统计学分析。结果:入院时,早康复组VAS评分高于晚康复组,差异有统计学意义(P<0.05),出院时、随访时,两组VAS评分均低于入院时,差异均有统计学意义(P<0.05),而两组VAS评分比较,差异均无统计学意义(P>0.05);早康复组住院期间VAS评分改善值大于晚康复组,差异有统计学意义(P<0.05)。入院时,早康复组屈膝角度小于晚康复组,伸膝受限角度大于晚康复组,差异有统计学意义(P<0.05);出院时、随访时,两组屈膝角度均大于入院时,伸膝受限角度均小于入院时,早康复组屈膝角度大于晚康复组、伸膝受限角度均小于晚康复组,差异均有统计学意义(P<0.05);住院期间,早康复组屈膝角度改善值、伸膝受限角度改善值大于晚康复组,差异均有统计学意义(P<0.05)。入院时,早康复组IKDC评分低于晚康复组,差异有统计学意义(P<0.05);出院时,两组IKDC评分均高于入院时,早康复组IKDC评分仍低于晚康复组,差异有统计学意义(P<0.05);随访时,两组IKDC评分均高于出院时,早康复组IKDC评分高于晚康复组,差异均有统计学意义(P<0.05);住院期间,早康复组IKDC评分改善值高于晚康复组,差异有统计学意义(P<0.05)。结论:ACL断裂重建术后早、晚介入均能从康复治疗中受益,早介入康复治疗预后更好,花费时间更短。