关节内牵引结合滑动牵张术对肘关节功能障碍康复的影响  

Effect of Distraction and Slide Stretching on the Dysfunction of Elbow Joint

作　　者：万里 卞荣[1,2] 朱奕 陈思婧[1,2] 

机构地区：[1]南京医科大学第一附属医院 [2]江苏省人民医院康复医学中心,江苏南京210029

出　　处：《中国伤残医学》2012年第4期1-3,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的：肘关节创伤术后功能障碍的常用治疗方案为理疗、运动疗法结合手法治疗。本文探讨将肘关节滑动牵张及关节内牵引技术增加到治疗方案中,观察其对肘关节功能障碍康复的影响。方法：选择2009年1月-2011年12月南京医科大学第一附属医院康复医学科收治的膝关节创伤术后功能障碍患者110例,随机分为2组,对照组和治疗组各55例。对照组进行理疗、运动疗法及手法治疗,总的治疗时间为1h/d。10天为1个疗程,共进行4个疗程。治疗组增加肘关节滑动牵张及关节内牵引治疗,每次治疗时间为20分钟,1次/d。徒手操作技术包括：①肱骨关节面滑动牵张;②尺骨关节面关节内牵引;③桡骨关节面滑动牵张。评估：①患肘关节治疗前后的关节活动范围（ROM）②应用Barthel指数评定量表对患者的ADL进行评估并记录分值。作者对110例患者治疗前后的肘关节功能逐项进行评估。结果：纳入患者110例,分为2组,全部进入结果分析,无脱落。2组患者治疗4个疗程后肘关节ROM及ADL评分变化：①对照组治疗4个疗程后,肘关节ROM及ADL评分均提高,与本组治疗前比较差异有统计学意义（P〈0.05）;②治疗组治疗4个疗程后肘关节ROM及ADL评分均明显提高,与本组治疗前比较差异有统计学意义（P〈0.05）;与对照组治疗后比较差异有统计学意义（P〈0.05）。结论：肘关节内牵引及滑动牵张技术对提高肘关节运动功能,改善肘关节活动范围有显著的康复效用。To investigate the interventional effect of distraction and slide stretching with the traditional method on the patients with dysfunction of elbow joint as combination of physical modalities , physical therapy and massage is a conventional method for the treatment of elbow joint dysfunction. Methods： One hundred and ten patients with elbow joint dysfunction hospitalized in the department of rehabilitation medicine, the First Affiliated Hospital of Nanjing Medical University from January 2009 to December 2011 were randomly divided into the sliding traction group （n=55） and control group （n=55）. Patients received one hour therapy including physical modalities, physical therapy and massage one after another everyday as one session. Patients in the distraction and slide stretching group received the same therapy as in the control group, adding elbow joint distraction and slide stretching in each session, included： ① slide stretching of humeroulnar articulation, ②slide stretching of humeroradial articulation , ③ distraction of humeroulnar articulation ④slide stretching of radioulnar articulation .In both groups, ten treatment sessions added up to one course, and all the patients were treated for four courses. ROM and Barthel index of the elbow joint were evaluated before and after treatment. Results： All patients were involved in the result analysis. ①after 4-coupes treatment, scores on ROM and Barthel index of the elbow joint were improved obviously in the two groups（P〈0.05）. ②The scores on ROM and Barthel index of the elbow joint were significantly higher in the distraction and slide stretching group than in the control group（P〈0.05）.Conclusion： The elbow jiont distraction and slide stretching can improve the motor function of elbow joint, and thus can improve the range of motion of elbow joint.

关 键 词：关节内牵引 滑动牵张 肘关节 康复 

分 类 号：R493[医药卫生—康复医学]