膝关节置换术后患者院内康复锻炼行为影响因素研究  

Research on the Influencing Factors of In-Hospital Rehabilitation Exercise Behavior of Patients after Knee Joint Replacement

作　　者：朱民[1] ZHU Min(Department of Orthopedics,Northern Jiangsu People's Hospital,Yangzhou,Jiangsu 225002,China)

机构地区：[1]江苏省苏北人民医院骨科,江苏扬州225002

出　　处：《转化医学杂志》2024年第11期1982-1985,共4页Translational Medicine Journal

基　　金：扬州市科技项目(K20210743)。

摘　　要：目的探究早期恢复期初次全膝关节置换术(TKA)后患者连续被动运动方法的有效性。方法选取2023年1月至2024年1月在江苏省苏北人民医院骨科接受TKA的100例患者为研究对象,根据康复计划将其分为冷敷单独治疗组(对照组,n=50)和冷敷+连续被动运动联合治疗组(试验组,n=50)。开展院内康复训练,评估患者康复锻炼自我效能,术前及术后关节屈曲角度、膝关节灵活性、骨关节炎指数(WOMAC)疼痛评分变化,以及术后患者的临床特征。结果不同年龄TKA患者的康复锻炼自我效能水平不同(P<0.05),年龄≥80岁的患者康复锻炼自我效能水平相对较低。术后关节屈曲角度、膝关节灵活性、WOMAC疼痛评分均较术前明显改善(P均<0.05);冷敷+连续被动运动联合治疗对膝关节的屈曲角度、WOMAC疼痛评分均无改善(P均>0.05),但可有效改善膝关节灵活性(P<0.05)。结论年龄是患者康复锻炼自我效能的影响因素,TKA患者术后加入连续被动运动,有助于恢复关节活动范围、改善膝关节灵活性。Objective To explore the effectiveness of the continuous passive motion method after primary total knee arthroplasty(TKA)during the early recovery period.Methods One hundred patients who underwent total knee arthroplasty(TKA)in the Department of Orthopedics of Subei People's Hospital in Jiangsu Province from January 2023 to January 2024 were selected as the research subjects.According to the rehabilitation plan,they were divided into the cold compress alone treatment group(control group,n=50)and the combined treatment group of cold compress and continuous passive motion(experimental group,n=50).In-hospital rehabilitation training was carried out to evaluate the self-efficacy of rehabilitation exercise,the changes in the flexion angle,knee joint flexibility,and Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)pain score of patients before and after surgery.Additionally,the improvement in the clinical characteristics and pain scores of patients after the cold compress alone treatment and the combined treatment of cold compress and continuous passive motion treatment was assessed.Results The self-efficacy levels of rehabilitation exercise were different among TKA patients of different ages(P<0.05),and the self-efficacy level of exercise was relatively low in patients aged≥80 years.The postoperative flexion angle of the joint,knee joint flexibility,and WOMAC pain score significantly improved compared with those before the surgery(P<0.05 for all).Adding continuous passive motion to the cold compress alone treatment did not significantly improve the knee flexion angle and WOMAC pain score(P>0.05 for all),but could effectively improve the joint flexibility(P<0.05).Conclusion Age is a factor affecting the self-efficacy of patients'exercise.Adding continuous passive motion after TKA surgery helps to restore the range of joint motion and improve the flexibility of the knee joint.

关 键 词：膝关节置换术 院内康复 锻炼自我效能 连续被动运动 

分 类 号：R687.4[医药卫生—骨科学]