两种康复方案下前交叉韧带重建术后本体感觉恢复程度的比较  

Comparison of two rehabilitation protocols to promote proprioception of the knee following anteriorcruciate ligament reconstruction

作　　者：周蓓[1] 韩琼[1] 张青松[1] 彭永海[1] 李烨[1] 任义军[1] 

机构地区：[1]华中科技大学同济医学院附属普爱医院骨科,武汉430033

出　　处：《中华创伤骨科杂志》2013年第5期421-424,共4页Chinese Journal of Orthopaedic Trauma

摘　　要：目的比较两种康复方案下关节镜下前交叉韧带（ACL）重建术后本体感觉的恢复程度。方法回顾性分析2007年08月至2010年6月期间接受ACL重建术的50例ACL损伤患者，根据不同时间段康复方案的不同分为两组：普通康复组25例，男18例，女7例；平均年龄为（27.4±3.3）岁，术后患者在支具保护下行直腿抬高及股四头股等长收缩锻炼等。本体感觉康复组25例，男16例，女9例；平均年龄为（26.4±3.6）岁；术后患者行无支具膝关节伸屈锻炼、变异适应性练习、动态平衡性练习及经皮电神经刺激等。分别于术前、术后3个月、6个月、12个月测定患者的本体感觉，并用差值百分比[=（术前本体感觉-术后本体感觉）/术后本体感觉×100%]表示患膝本体感觉的恢复程度。结果所有患者术后获12～24个月（平均14个月）随访。术后3个月，两组患者在屈膝15°、45°和75°时本体感觉恢复程度比较差异均无统计学意义（P〉0.05）。术后6、12个月，本体感觉康复组患者屈膝15°、45°和75°时本体感觉恢复程度均优于普通康复组（术后12个月本体感觉恢复程度平均分别为-50.2%±13.3% vs. -27.5%±7.7%、 -64.3%±16.9% vs. -38.4%±7.6%、-60.3%±14.1%vs. -35.1%±7.6%）,差异均有统计学意义（P〈0.05）。结论变异适应性练习、辅以动态平衡性练习及经皮电神经刺激的康复方案有利于患者在静态、匀速动态、变异动态中重建神经、肌肉的协调性，对膝关节ACL重建术后患者的 体感觉恢复具有积极参加促进作用。Objective To compare the effects of 2 rehabilitation protocols on promotion of proprioception of the the knee after anterior cruliate ligament （ACL） reconstruction. Methods We retrospectively reviewed 50 patients who had undergone an ACL reconstruction between August 2007 and June 2010 in our institution. They were divided into 2 groups according to their rehabilitation protocols. In the normal rehabilitation （NR） group there were 18 men and 7 women with an average age of 27.4±3.3 years. They were trained to do straight leg raising and quadriceps isometric aontraction under the protection of brace early after operation. In the proprioception rehabilitation （PR） group, there were 16 men and 9 women with an average age of 26.4±3.6 years. They were trained to do motion exercise without brace early after operation, and received perturbation training （roller board and tilt board）, dynamic balance training with treadmill and transcutaneous electrical nerve stimulation. Proprioception assessment was performen pre-reconstruction and at 3,6 and 12 months post-reconstruction. Proprioception recovery was expressed by difference percentage [= （pre-reconstruction proprioception - post-reconstruction proprioception）/ post-reconstruction proprioception-×100%]. Results The 2 groups showed no significant differences at the knee flexion of 15°、45°and 75°in proprioception recovery at 3 months post-reconstruction（P〉0.05）. At 6 and 12 months post-reconstruction. the PR group had significantly better proprioception recovery at the knee flexion of 15°、45°and 75° than the NR group （-50.2%±13.3% vs. -27.5%±7.7%、 -64.3%±16.9% vs. -38.4%±7.6%、-60.3%±14.1%vs. -35.1%±7.6% respectively at 12 months post-reconstruction） （P〈0.05）. Conclusion The protocol of early motion exercise in combination with perturbation training, dynamic balance training and transcutaneous eletrical nerve stimulation can better promote proprioception recovery of the knee joint after ACL reconstruction because t

关 键 词：前交叉韧带 本体感觉 关节镜检查 康复 

分 类 号：R687.4[医药卫生—骨科学]