膝骨关节炎患者动静态跌倒风险测试的临床应用价值  

Clinical Value about Static Fall Index Test and Dynamic Fall Index Test for Patients with Knee Osteoarthritis

作　　者：郭燕梅[1] 陈蔚[1] 焦伟国[1] 朱才兴[1] 彭楠[1] 王娜[1] 

机构地区：[1]解放军总医院南楼临床部康复医学科,北京市100853

出　　处：《中国康复理论与实践》2011年第9期856-860,共5页Chinese Journal of Rehabilitation Theory and Practice

基　　金：解放军总医院科技创新基金(09KMM22)

摘　　要：目的探讨膝骨关节炎(KOA)患者的平衡功能状况和动静态跌倒风险测试在KOA患者中的临床应用价值。方法对无膝痛的KOA患者(对照组,n=30)给予静态姿势稳定性(PS)、姿势稳定极限性(LOS)、动态跌倒风险指数(DFI)和静态跌倒风险指数(SFI)测试。对有膝痛的KOA患者(治疗组,n=30)给予10次双氯芬酸二乙胺乳胶剂经脉冲超声波导入和6次推拿手法联合治疗,并于治疗前后给予西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分及上述4种平衡功能测试。结果对照组与治疗组治疗前在PS总分、前后摆动系数、侧向摆动系数存在显著性差异(P<0.05);LOS完成时间、LOS总分和DFI存在非常显著性差异(P<0.01),而SFI无显著性差异(P>0.05)。治疗组治疗前后的WOMAC得分、PS总分、前后摆动系数、LOS完成时间、LOS总分和DFI存在显著性差异(P<0.05);侧向摆动系数、SFI无显著性差异(P>0.05)。结论有膝痛的KOA患者与年龄相匹配的无膝痛KOA受试者相比,平衡功能更差,跌倒风险更大。经有效治疗后,KOA患者的平衡功能明显改善,跌倒风险降低。与SFI测试相比,DFI测试对KOA患者平衡功能改善更加敏感。Objective To investigate the balance function of the knee osteoarthritis（KOA） patients and the clinical value about static fall index test and dynamic fall index test for the patients with knee osteoarthritis.Methods The osteoarthritis patients without knee pain（con-trol group,n=30） were tested with postural stability（PS）,limits of stability（LOS）,dynamic fall index（DFI） and static fall index（SFI）.The osteoarthritis patients with knee pain（treatment group,n=30） accepted 10 times of diclofenac diethylamine emulge imported by pulsed ultra-sound and 6 times of massage therapy.They were also tested with above four balance tests and Western Ontario and McMaster Universities Osteoarthritis Index（WOMAC） before and after treatments.Results There was significant difference in overall of PS,anterior/posterior in-dex and medial lateral index（P0.05） between the control group and the treatment group before treatments,and there was very significant difference in time to complete LOS,overall of LOS and DFI（P0.01）;but there was no significant difference in SFI（P0.05）.There was significant difference in WOMAC scores,overall of PS,anterior/posterior index,time to complete LOS,overall of LOS and DFI（P0.05） in the treatment group before and after treatments,but there was no significant difference in medial lateral index and SFI（P0.05）.Conclusion Compared with osteoarthritis patients without knee pain,KOA patients with knee pain are in poorer balance function and greater fall risk.After effective treatments,the balance function and fall risk of the KOA patients may significantly improve.Compared with SFI test,the DFI test is more sensitive to the improvement of balance function of the KOA patients.

关 键 词：老年 膝骨关节炎 平衡 跌倒 

分 类 号：R684.3[医药卫生—骨科学]