主动杠杆试验评价前交叉韧带重建术后早期功能康复时机的研究  

The Timing of Early Rehabilitation after Anterior Cruciate Ligament Reconstruction Based on the Active Lever Test

作　　者：李莉[1] 王梓 尹梦虹 王一腾 李庆[1] 齐志明[1] Li Li;Wang Zi;Yin Menghong;Wang Yiteng;Li Qing;Qi Zhiming(Department of Sports Medicine,Dalian Municipal Central Hospital,Liaoning 116033,China)

机构地区：[1]大连市中心医院运动医学科

出　　处：《中国运动医学杂志》2019年第10期845-850,共6页Chinese Journal of Sports Medicine

摘　　要：目的:探讨主动杠杆试验评价前交叉韧带重建术后精准康复时机的可行性。方法:选取关节镜下前交叉韧带断裂重建术患者64例,随机分为实验组和对照组,各32例。对照组采用常规康复方案,实验组按照患者完成主动杠杆试验的情况决定术后康复时机并指导康复治疗。分别于术前、术后1w、2w、4w、12w及24w对两组患者进行膝关节胫骨前移度(KT-2000)、主动关节活动度(ROM)以及膝关节功能Lysholm评分,并记录两组患者术后脱拐时间。结果:术后6周内,实验组Lysholm评分高于对照组(P<0.05),12周后差异无统计学意义;实验组ROM高于对照组(P<0.05),到12周两组基本一致。术前及术后各个时间点,两组膝关节胫骨前移度差异均无统计学意义(P>0.05)。实验组脱拐时间平均为28.0天,对照组平均为44.6天,实验组脱拐时间早于对照组(P<0.05)。采用Kaplan-Meier和LogRank检验进行以脱拐时间为终点事件的生存分析,结果同样是实验组脱拐时间早于对照组(P<0.05)。结论:主动杠杆试验结果可作为评价前交叉韧带重建术后康复训练时机的可靠指标,为建立个体化的康复方案提供科学依据。Objective To explore the feasibility of evaluating the precise timing of rehabilitation after anterior cruciate ligament reconstruction with the active lever test.Methods Sixty-four patients receiving the anterior cruciate ligament reconstruction under the arthroscope were recruited and randomly divided into an experimental group and a control group,each of 32.The control group was given routine reha bilitation treatment,while the experimental group was evaluated using the active lever test to decide on the optimal rehabilitation time and given treatment accordingly.KT-2000,ROM and Lysholm score were used to measure the knees before as well as 1,2,4,12 and 24 weeks after the surgery.The time of free walking was recorded.Results The average Lysholm score and the ROM level of the experi mental group were significantly higher than the control group(P<0.05)within 6 weeks after the sur gery,showing no significant differences after 12 weeks.No significant differences were found in the KT-2000 between the two groups at any time points(P>0.05).The average time of free walking was 28.0 days after the surgery in the experimental group,significantly earlier than the control group of 44.6 days,verified by Kaplan-Meier test and LogRank test(P<0.05).Conclusion The results of active lever test are reliable indicators for early rehabilitation and can provide scientific evidences for setting up individualized rehabilitation programs after the anterior cruciate ligament reconstruction.

关 键 词：主动杠杆试验 前交叉韧带重建术 早期 康复时机 

分 类 号：R47[医药卫生—护理学]