经颅直流电刺激前交叉韧带重建术后康复效果研究  

Rehabilitation effect of transcranial direct-current stimulation after anterior cruciate ligament reconstruction

作　　者：宋炎成 曹明德 许华亮 张俊辉 昌宏 王华 SONG Yancheng;CAO Mingde;XU Hualiang;ZHANG Junhui;CHANG Hong;WANG Hua(Department of Orthopaedics,the First Affiliated Hospital of Guangdong Pharmaceutical University,Guangzhou 510080,China)

机构地区：[1]广东药科大学附属第一医院骨科,广东广州510080

出　　处：《广东药科大学学报》2021年第4期96-100,144,共6页Journal of Guangdong Pharmaceutical University

基　　金：广东省医学科研基金项目(B2019049);广东省中医药局项目(20191204)。

摘　　要：目的探讨经颅直流电刺激(tDCS)对前交叉韧带损伤重建术后康复疗效。方法选取2018年1月-2020年4月广东药科大学附属第一医院关节镜下单束前交叉韧带断裂重建术患者60例,随机分为观察组和对照组各30例。对照组采用常规康复方案,观察组在常规康复基础上,增加基于Halo装置的经颅直流电刺激下的平衡及本体感觉锻炼。分别于术前、术后3个月、6个月及12个月对两组患者膝关节Lysholm功能评分、被动活动察觉阈值测试以及全身动态平衡测试。结果术后所有患者均获得12个月随访。两组患者随时间延长Lysholm评分显著增加,不同时间点差异有统计学意义(P<0.05),术后6个月、12个月时,观察组的Lysholm评分高于对照组,差异有统计学意义(P<0.05);术后被动活动察觉阈值测试(threshold to detection of passive motion,TTDPM)随时间延长而显著改善(P<0.05),术后3个月观察组患者被动活动察觉阈值显著低于对照组(P<0.05);全身动态平衡测试(whole-body dynamic balancing task,DBT)3个月时水平差异无统计学意义(P>0.05),术后6、12个月时,观察组均优于对照组,差异具有统计学意义(P<0.05)。结论基于Halo装置的tDCS可应用于交叉韧带重建术后患者,改善功能及本体感觉,促进患者早期康复。Objective To investigate the rehabilitation effect of transcranial direct-current stimulation(tDCS)on anterior cruciate ligament(ACL)reconstruction.Methods From January 2018 to April 2020,sixty patients treated with arthroscopy single-bundle ACL reconstruction were randomly divided into the experimental group and the control group,with 30 cases in each group.The control group used a conventional rehabilitation program,and the experimental group increased tDCS by utilizing the Halo device on the basis of conventional rehabilitation.The Lysholm function score,threshold to detection of passive motion(TTDPM)and whole-body dynamic balancing task(DBT)score were measured before and after surgery at 3,6 and 12 months.Results All patients were followed up for more than 12 months.The Lysholm scores of both groups were significantly increased with time,and the differences at various time points were statistically significant(P<0.05).At 6 and 12 months after surgery,the Lysholm score of the experimental group was higher than the control group(P<0.05).TTDPM were significantly improved with time(P<0.05),and the passive activity detection threshold of the experimental group was significantly lower than that of the control group at 3 months after operation(P<0.05).The whole-body dynamic balancing task(DBT)showed no significant difference between two groups at 3 months,but the experimental group was superior to the control group at 6 and 12 months(P<0.05).Conclusion Transcranial direct-current stimulation based on Halo device can be applied to patients after anterior cruciate ligament reconstruction,which may improve the muscle strength of patients,promote proprioceptive recovery,and promote comprehensive rehabilitation of patients.

关 键 词：经颅直流电刺激 前交叉韧带重建术 本体感觉 康复 

分 类 号：R454.1[医药卫生—治疗学]