不同强度体外冲击波治疗创伤性伸直型膝关节挛缩的疗效分析  

Analysis of therapeutic effect of extracorporeal shock wave with different intensity on traumatic extended knee joint contracture Download Fulltext

作　　者：张润 张全兵[1,2] 周云[1,2] 阚秀丽[1,2] 王永召[1,2] 周涵 李凯 熊斌[1,2] ZHANG Run;ZHANG Quanbing;ZHOU Yun(Department of Rehabilitation Medicine,The Second Affiliated Hospital of Anhui Medical University,Hefei,230601)

机构地区：[1]安徽医科大学第二附属医院康复医学科,合肥市230601 [2]安徽医科大学第二附属医院转化医学研究中心

出　　处：《中国康复医学杂志》2024年第11期1625-1631,共7页Chinese Journal of Rehabilitation Medicine

基　　金：安徽省卫生健康科研项目(AHWJ2022b063);安徽省卫生健康科研项目(AHWJ2023A30077);安徽医科大学第二附属医院国自然孵育计划项目(2022GMFY05);安徽医科大学高峰学科(临床医学)学科建设项目(2022GFXK—EFY08);安徽医科大学2023年学科建设项目(2023lcxk EFY010)。

摘　　要：目的:探讨不同强度体外冲击波疗法(extracorporeal shock wave therapy,ESWT)对创伤性伸直型膝关节挛缩的疗效影响。方法:选取2021年5月—2023年7月于安徽医科大学第二附属医院康复医学科住院治疗的创伤性伸直型膝关节挛缩患者80例,用随机数字表法将其随机分为4组,每组20例。每组在常规康复治疗的基础上,分别以1.5bar、2.0bar、2.5bar和3.0bar的强度行体外冲击波治疗。治疗前后分别测量患者的主动屈膝角度、根据Lysholm膝关节评分量表评定Lysholm评分、运用TecnoBody数字化跑台系统采集步速、健侧负重比和双侧触地时长差值,对治疗后各项指标进行对比分析。结果:治疗前,各组患者的一般信息和各项评定指标比较均无显著性差异(P>0.05)。治疗后,各组患者的主动屈膝角度、Lysholm评分、步速、健侧负重比和双侧触地时长差值较治疗前均明显改善(P<0.05)。治疗后4组各项指标对比发现,2.0bar和2.5bar组的主动屈膝角度、Lysholm评分和健侧负重比的改善程度均优于1.5bar和3.0bar组(P<0.05);2.0bar、2.5bar和3.0bar组的步速均优于1.5bar组(P<0.05),但2.5bar组的速度最高(P<0.05);2.0bar、2.5bar和3.0bar组的双侧触地时长差值均低于1.5bar组(P<0.05),但3组两两比较,差异无显著性(P>0.05)。结论:4组不同强度的体外冲击治疗均可改善创伤性伸直型膝关节挛缩患者的主动屈膝角度、膝关节功能和步态,但2.0bar和2.5bar强度ESWT的整体疗效更好,建议在临床应用中选择2.0—2.5bar范围内的强度。Objective:To explore the effect of extracorporeal shock wave therapy(ESWT)with different intensity on traumatic extended knee joint contracture.Method:From May 2021 to July 2023,80 patients with traumatic extended knee joint contracture who were hospitalized in the Department of Rehabilitation Medicine of the Second Affiliated Hospital of Anhui Medical University were selected and randomly divided into 4 groups with 20 cases in each group.On the basis of routine rehabilitation treatment,each group performed ESWT at the intensity of 1.5bar,2.0bar,2.5bar and 3.0bar respectively.Before and after treatment,the active knee flexion angle and the Lysholm score were measured,the walking speed,the load ratio of the healthy side and the difference of bilateral touchdown time were collected by TecnoBody digital treadmill system.All the indexes were compared and analyzed after treatment.Result:Before treatment,there were no significant differences in the general information and evaluation indexes among the four groups(P>0.05).After treatment,the active knee flexion angle,Lysholm score,walking speed,the load ratio of the healthy side and the difference of bilateral touchdown time were significantly improved compared with those before treatment in all groups(P<0.05).After treatment,the indexes of the four groups were compared.It was found that the degree of improvement for active knee flexion angle,Lysholm score and the load ratio of the healthy side in the 2.0bar and 2.5bar groups were better than those in the 1.5bar and 3.0bar groups(P<0.05).The walking speed of 2.0bar,2.5bar and 3.0bar groups were better than that of 1.5bar group(P<0.05),and the speed of 2.5bar group was the highest(P<0.05).The difference of bilateral touchdown time of 2.0bar,2.5bar and 3.0bar groups were all lower than that of 1.5bar group(P<0.05),but there was no statistical difference among the three groups(P>0.05).Conclusion:The extracorporeal shock wave therapy with different intensities can improve the active knee flexion angle,knee function and gait

关 键 词：伸直型膝关节挛缩 体外冲击波疗法 强度 步态分析 

分 类 号：R493[医药卫生—康复医学]