全膝关节置换术后阶段性目标康复锻炼方案的建立及应用  

Establishment and application of staged target rehabilitation exercise program after total knee arthroplasty

作　　者：田凤娟 高金勇 郑艳[1] 张敏[1] TIAN Feng-juan;GAO Jin-yong;ZHENG Yan;ZHANG Min(Department of Orthopedics,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan,CHINA;Department of Anesthesiology,the Third People's Hospital of Henan Province,Zhengzhou 450052,Henan,CHINA)

机构地区：[1]郑州大学第一附属医院骨科,河南郑州450052 [2]河南省第三人民医院麻醉科,河南郑州450052

出　　处：《海南医学》2025年第1期120-124,共5页Hainan Medical Journal

基　　金：2023年度河南省医学科学院青年医学科研人员研究项目(编号:QNYJ2023013)。

摘　　要：目的探讨全膝关节置换术(TKA)术后阶段性目标康复锻炼方案的应用效果。方法选取2020年2月至2023年10月郑州大学第一附属医院收治的82例行TKA治疗的患者作为研究对象,按随机数表法分为对照组和研究组各41例。对照组患者采用常规干预,研究组患者在对照组护理的基础上联合阶段性目标康复锻炼方案。两组患者均护理干预至出院,出院随访12周后回院复查。比较两组患者干预前及随访12周后的康复锻炼依从性、恐动症Tampa评分(TSK)、美国特种外科医院评分(HSS)、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分以及关节活动度。结果干预前,两组患者的康复锻炼依从性、TSK评分比较差异均无统计学意义(P>0.05);随访12周后,两组患者康复锻炼依从性均升高,TSK评分均下降,且研究组患者康复锻炼依从性评分为(55.03±6.91)分,明显高于对照组的(48.06±5.14)分,TSK评分为(35.88±4.81)分,明显低于对照组的(42.31±4.06)分,差异均有统计学意义(P<0.05);随访12周后,两组患者HSS评分均升高,WOMAC评分均下降,且研究组患者HSS评分为(78.29±6.19)分,明显高于对照组的(69.53±5.11)分,WOMAC评分为(40.09±7.62)分,明显低于对照组的(48.15±5.83)分,差异均有统计学意义(P<0.05);随访12周后,两组患者的关节主动活动度、关节被动活动度均升高,且研究组患者关节主动活动度、关节被动活动度分别为(89.95±10.34)°、(115.37±14.02)°,明显高于对照组的(83.63±8.53)°、(107.52±11.25)°,差异均有统计学意义(P<0.05)。结论阶段性目标康复锻炼方案能够提高TKA患者术后康复锻炼依从性,降低术后运动恐惧感,改善膝关节功能。Objective To study the application effect of staged target rehabilitation exercise program after total knee arthroplasty(TKA).Methods Eighty-two patients receiving TKA treatment in the First Affiliated Hospital of Zhengzhou University from February 2020 to October 2023 were selected and divided into a control group and a study group by random number table method,with 41 patients in each group.The control group adopted routine management,and the study group applied staged target rehabilitation exercise program on the basis of the treatment in the control group.Patients in both groups were given nursing intervention until discharge,and they were followed up for 12 weeks before returning to the hospital for reexamination.The compliance of rehabilitation exercise,Tampa Scale for Kinesiophobia(TSK),Hospital for Special Surgery(HSS)score,and the Western Ontario and McMaster Universities Arthritis Index(WOMAC),and joint range of motion were compared between the two groups before intervention and after 12 weeks of follow-up.Results Before intervention,there was no significant difference in compliance of rehabilitation exercise and TSK score between the two groups(P>0.05).After 12 weeks of follow-up,the compliance of rehabilitation exercise in both groups increased,and the TSK score decreased;the compliance score of rehabilitation exercise of patients in the study group was(55.03±6.91)points,which was significantly higher than(48.06±5.14)points of the control group;the TSK score was(35.88±4.81)points,which was significantly lower than(42.31±4.06)points of the control group;the differences were statistically significant(P<0.05).After 12 weeks of follow-up,HSS score increased and WOMAC score decreased in both groups;HSS score in the study group was(78.29±6.19)points,which was significantly higher than(69.53±5.11)points in the control group;WOMAC score was(40.09±7.62)points,which was significantly lower than(48.15±5.83)points of the control group;the differences was statistically significant(P<0.05).After 12 weeks of

关 键 词：膝骨性关节炎 全膝关节置换术 阶段性目标康复锻炼方案 依从性 运动恐惧 美国特种外科医院评分 西安大略和麦克马斯特大学骨关节炎指数 

分 类 号：R473.6[医药卫生—护理学]