下肢康复机器人联合本体感觉训练用于军事训练伤前交叉韧带重建术后的短期疗效  

Short-term effects of limb rehabilitation robot combined with proprioceptive training on functional recovery following military training-related anterior cruciate ligament reconstruction

作　　者：李宝 张文婷 崔向红 王娅婷 赵业如 元红 刘欣伟 Li Bao;Zhang Wenting;Cui Xianghong;Wang Yating;Zhao Yeru;Yuan Hong;Liu Xinwei(General Hospital of Northern Theater Command,Shenyang 110016,China;The Graduate School of China Medical University,Shenyang 110122,China;Dalian Rehabilitation and Rehabilitation Center of PLA Joint Logistic Support Force,Dalian,Liaoning Province 116000,China)

机构地区：[1]北部战区总医院骨科,沈阳110016 [2]中国医科大学研究生院,沈阳110122 [3]中国人民解放军联勤保障部队大连康复疗养中心,辽宁大连116000

出　　处：《创伤外科杂志》2024年第6期405-409,共5页Journal of Traumatic Surgery

基　　金：辽宁省科学技术计划项目(2022YGJC-07)。

摘　　要：目的探讨下肢康复机器人联合本体感觉训练应用在膝关节镜前交叉韧带重建术后的临床疗效。方法回顾性分析2021年12月—2023年6月北部战区总医院诊治的膝关节前交叉韧带训练伤军人87例,男性83例,女性4例;年龄19~41岁,平均30.2岁;均为军事训练致伤。病例均于北部战区总医院行关节镜下前交叉韧带重建术。按照术后康复方案不同分为观察组(43例)和对照组(44例)。观察组采用常规康复方案结合下肢康复机器人和本体感觉练习方案,对照组采用单纯常规康复方案,康复训练时间设置为8周。于术后第2、4、8周评估并比较两组患者的IKDC评分、Lysholm评分、VAS和Gait watch步态分析动态数据。结果全部病例随访9~54周,平均33.6周。术后两组患者各时间段VAS比较差异无统计学意义(P>0.05);两组患者IKDC评分、Lysholm评分和Gait watch步态分析动态数据在术后第2周比较差异无统计学意义(P>0.05)。术后第4周,IKDC评分、Lysholm评分比较差异无统计学意义(P>0.05),Gait watch步态分析动态数据观察组优于对照组[步长(67.7±7.8)cm vs.(64.4±7.1)cm;步频(89.0±9.2)步/min vs.(85.5±7.4)步/min;步速(83.2±5.9)cm/s vs.(77.8±6.5)cm/s,P<0.05]。术后第8周,观察组IKDC评分(7.0±0.8)分vs(6.4±0.9)分、Lysholm评分(74.6±5.5)分vs.(69.1±6.1)分和Gait watch步态分析动态数据[步长(75.5±5.8)cm vs.(67.4±7.6)cm;步频(103.3±7.6)步/min vs.(89.1±9.4)步/min;步速(98.2±10.3)cm/s vs.(89.2±8.2)cm/s]优于对照组(P<0.05)。结论下肢康复机器人联合本体感觉训练有益于前交叉韧带重建术后膝关节功能的早期恢复并可帮助伤者快速重返运动和训练。Objective To explore the clinical effect of limb rehabilitation robot combined with proprioceptive training in knee arthroscopic anterior cruciate ligament(ACL)reconstruction.Methods A retrospective analysis was conducted on 87 cases of knee ACL injuries following military training,who were treated at the General Hospital of Northern Theater Command by arthroscopic ACL reconstruction.There were 83 males and 4 females aged 19-41(mean 30.2)years.Patients were divided into two groups according to the postoperative rehabilitation plans:patients in the observation group received limb rehabilitation robot-assisted training combined with proprioceptive training(n=43)while those in the control group received only conventional rehabilitation(n=44).The rehabilitation training time was set as 8 weeks for all patients.The IKDC score,Lysholm score,VAS,and dynamic gait analysis data by Gait-watch were recorded at 2,4 and 8 weeks after surgery.Results Patients were followed up for 9-54(mean 33.6)weeks.At the three observational time points,VAS revealed no significant difference(P>0.05 for all time points),Gait-watch showed much better dynamic gait data in the observation group than in the control group at postoperative 4 weeks(step length:cm,67.7±7.8 vs.64.4±7.1;step frequency:steps/min,89.0±9.2 vs.85.5±7.4;step speed:cm/s,83.2±5.9 vs.77.8±6.5)and 8 weeks(step length:cm,75.5±5.8 vs.67.4±7.6;step frequency:steps/min,103.3±7.6 vs.89.1±9.4;step speed:cm/s,98.2±10.3 vs.89.2±8.2,all P<0.05),while the IKDC score and Lysholm score only showed significantly better results at postoperative 8 weeks in the observation group than in the control group(IKDC score 7.0±0.8 vs.6.4±0.9;Lysholm score 74.6±5.5 vs.69.1±6.1,both P<0.05).Conclusion Lower limb rehabilitation robot combined with proprioceptive training is beneficial for the early recovery of knee function after ACL reconstruction.

关 键 词：军事训练伤 膝前交叉韧带 关节镜 下肢康复机器人 本体感觉 

分 类 号：R687.4[医药卫生—骨科学]