悬吊运动疗法在青年军人膝关节前交叉韧带重建同期半月板缝合术后康复中的作用  

Sling exercise therapy in the rehabilitation of young soldiers after knee joint anterior cruciate ligament reconstruction and simultaneous meniscal suture

作　　者：徐丹 黎华茂 杨慧 卫星 刘曦明 丁然 黄礼群 许萌 Xu Dan;Li Huamao;Yang Hui;Wei Xing;Liu Ximing;Ding Ran;Huang Liqun;Xu Meng(Department of Rehabilitation Medicine,Central Theater Command General Hospital,Wuhan 430070,China;Department of Orthopedics,Central Theater Command General Hospital,Wuhan 430070,China)

机构地区：[1]中部战区总医院康复医学科,武汉430070 [2]中部战区总医院骨科,武汉430070

出　　处：《创伤外科杂志》2023年第8期579-585,共7页Journal of Traumatic Surgery

基　　金：湖北省自然科学基金青年项目(2022SFB848)。

摘　　要：目的探讨常规治疗方案的基础上配合悬吊运动疗法(sling exercise therapy,SET)对青年军人膝关节前交叉韧带(anterior cruciate ligament,ACL)重建同期半月板缝合术后膝关节功能障碍的康复疗效。方法回顾性分析2020年4月—2022年6月中部战区总医院行单侧膝关节ACL重建同期半月板缝合术后接受常规康复治疗的军队青年患者67例,男性66例,女性1例;年龄19~40岁,平均年龄27.1岁。按是否进行SET分为对照组(30例)和SET组(37例)。对照组男性29例,女性1例;年龄20~38岁,平均28.4岁;损伤部位:左膝16例,右膝14例;术后转至康复医学科的时间为8~28d,平均18.6d;康复训练前平衡分级Ⅰ级2例,Ⅱ级26例,Ⅲ级2例。SET组37例均为男性,年龄19~40岁,平均26.1岁;损伤部位:左膝14例,右膝23例;术后转至康复医学科的时间为8~30d,平均16.3d;SET训练前平衡分级Ⅰ级3例,Ⅱ级30例,Ⅲ级4例。对照组采取常规治疗方案,包括:关节松动术、肌力训练、超声波治疗、冷疗等;SET组在常规康复训练的基础上于手术后1个月开始融入SET(包括:开链训练、闭链训练及膝关节本体感觉训练)。比较两组患者膝关节训练前和训练后1、2个月视觉模拟评分(visual analogue scale,VAS)、关节活动度(range of motion,ROM)、膝关节功能(Lysholm评分);训练后2个月下肢平衡功能(Y-balance test,YBT)。结果两组患者年龄、性别、损伤部位、术后转至康复医学科时间、SET训练前平衡分级比较差异无统计学意义(P>0.05)。SET组训练后1、2个月VAS、ROM、Lyscholm评分均优于对照组[(2.2±0.4)分vs.(2.8±0.4)分、(1.1±0.4)分vs.(1.8±0.4)分;(119.5±8.2)°vs.(114.8±7.3)°、(134.1±8.2)°vs.(129.9±7.5)°;(74.8±4.6)分vs.(67.7±5.9)分、(82.7±4.6)分vs.(78.1±4.4)分],差异有统计学意义(P<0.05)。训练后2个月Y平衡测试,SET组正前侧、后内侧、后外侧伸出距离均优于对照组[(58.2±4.8)cm vs.(55.6±5.2)cm、(100.5±10.5)cm vs.(94.8±11.3)Objective To explore the rehabilitation effect of sling exercise therapy(SET)on knee joint dysfunction after unilateral knee-joint anterior cruciate ligament(ACL)reconstruction and simultaneous meniscal suture in young soldiers.Methods This retrospective analysis was conducted on 67 young soldiers who received rehabilitation treatment after unilateral knee-joint ACL reconstruction and simultaneous meniscal suture in the Central Theater Command General Hospital from Apr.2020 to Jun.2022.There were 66 male and 1 female aged 19-40 years,mean 27.1 years.According to whether SET was additionally conducted,patients were divided into control group(n=30)and SET group(n=37).For the control group,there were 29 male and 1 female aged 20-38 years,mean 28.4 years;16 cases affected the left knee and 14 the right;the time period from post-surgery to admission to the rehabilitation physiotherapy department was 8-28 d,mean 18.6 d;and the initial balance evaluation showed 2 cases of grade I,26 gradeⅡand 2 gradeⅢ.For the SET group,all the 37 patients enrolled were male,with the age range of 19-40 years,mean 26.1 years;14 cases affected the left knee and 23 the right;the time period from post-surgery to admission to the rehabilitation physiotherapy department was 8-30 d,mean 16.3 d;the initial balance evaluation before SET showed 3 cases of grade I,30 gradeⅡand 4 gradeⅢ.Both of the two groups received routine rehabilitation including joint mobilization,muscle training,ultrasound therapy,cryotherapy,etc;while patients in the SET group received additionally SET at 1 month after surgery,respectively kinetic chain exercise(open and closed)and proprioceptive training.The visual analog scale(VAS),range of motion(ROM),and knee function(Lysholm score)were recorded and compared between two groups before,1 and 2 months after training,as well as lower limb Y balance test(YBT)at 2 months after training.Results There was no significant difference between the control and SET groups in terms of age,sex,injury side,time from post-surgery to

关 键 词：前交叉韧带损伤 悬吊运动疗法 青年军人 半月板缝合 膝关节功能 康复 

分 类 号：R684[医药卫生—骨科学]