前交叉韧带重建术后患者运动恐惧心理与膝关节功能的相关性研究  

Observing the Relationships between Kinesiophobia and Knee Function after ACL Reconstruction

作　　者：何静 汪伍 黄春萌 冯伟[1] 蒋黎明[1,3] 厉坤鹏[2] HE Jing;WANG Wu;HUANG Chun-Meng;FENG Wei;JIANG Li-Ming;LI Kun-Peng(The Second Rehabilitation Hospital of Shanghai,Shanghai 200441;Shanghai University of Chinese Traditional Medicine,Shanghai 201203;The 7^(th)People's Hospital of Shanghai,Shanghai 200137)

机构地区：[1]上海中医药大学,上海201203 [2]上海市第二康复医院,上海200441 [3]上海市第七人民医院,上海200137

出　　处：《按摩与康复医学》2021年第23期22-26,共5页Chinese Manipulation and Rehabilitation Medicine

基　　金：2019上海市体育科技“腾飞计划”项目,编号:19T005。

摘　　要：目的:通过等速测试和膝关节功能量表评估探讨前交叉韧带重建术(ACLR)术后2年以上患者的运动恐惧心理与膝关节功能指标的相关性。方法:对19例ACLR术后2年以上患者进行膝关节损伤和骨关节炎评分(KOOS)及运动恐惧心理量表评分(TSK-17),根据KOOS量表中运动与娱乐能力项目得分将患者分为运动功能障碍组(10例)和运动功能正常组(9例),应用等速肌力测试系统(IsoMed2000)分别对两组患者双侧膝关节进行60°/s的等速测试,通过独立样本t检验或Wilcoxon秩和检验比较两组患者各测试评估指标之间的差异,通过Spearman相关分析研究运动功能障碍组患者的TSK-17分数与各膝关节功能指标之间的相关性。结果:(1)两组间患膝屈、伸肌力矩体重比,患膝屈伸比(HQ)差异有统计学意义(P<0.01);(2)两组间TSK-17评分,KOOS量表中的日常生活活动能力(P<0.05)、运动与娱乐能力(P<0.01)和膝关节相关生活质量评分(P<0.01)差异有统计学意义;(3)运动功能障碍组TSK-17评分分别与伸膝患健比(P<0.05,r=0.686)及KOOS量表中的疼痛(P<0.05,r=-0.822)、症状评分(P<0.05,r=-0.771)相关。结论:ACLR术后2年以上运动功能障碍患者存在较低的膝关节功能水平和较高的运动恐惧心理水平,且运动功能障碍患者的运动恐惧心理与膝关节的疼痛及不适症状显著相关。Objective:Explore the relationships between kinesiophobia and knee function among patients who are two years longer after anterior cruciate ligament reconstruction through isokinetic test and knee functional scale test.Methods:Divided the 19 patients who after taken anterior cruciate ligament reconstruction for longer than 2 years into abnormal activity group and normal activity group according to the score of KOOS chart.Patients taken the isokinetic test through IsoMed2000 in angular velocity of 60°/s.Compared the variance of the outcomes between two groups through independent sample t test or Wilcoxon rank sum test,analyzed the correlation between the score of TSK-17 and functional outcomes through Spearman correlation analysis.Results:(1)The peak torque to body weight ratio of flexors and extensors between the two groups are of significant difference(P<0.01),HQ between two groups is of significant difference(P<0.01);(2)Three parts of KOOS charts between two groups of are of significant difference(P<0.01);(3)There exist negative co-variation between the TSK-17 score and pain parts of the KOOS chart in abnormal group(P<0.05,r=-0.822),negative co-variation between the TSK-17 score and symptoms parts of the KOOS chart in abnormal group(P<0.05,r=-0.771),positive covariation between the TSK-17 score and knee extensor LSI.Conclusion:Patients in abnormal group are in low level function of the knee and high level of kinesiophobia,and there exist significant correlation between kinesiophobia and patient reported pain and symptoms of the knee in abnormal group.

关 键 词：前交叉韧带损伤 前交叉韧带重建术 运动恐惧 等速测试 相关性 

分 类 号：R493[医药卫生—康复医学] B842.6[医药卫生—临床医学]