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任跃兵,杨利民,张承韶,刘鲁平,滕学仁.等速运动训练在肘关节内骨折术后早期康复中的应用[J].中国康复医学杂志,2011,26(10):939~944
等速运动训练在肘关节内骨折术后早期康复中的应用    点此下载全文
任跃兵  杨利民  张承韶  刘鲁平  滕学仁
青岛大学医学院,山东青岛,266071
基金项目:
DOI:
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摘要:
      摘要 目的:探讨肘关节内骨折术后患者应用等速运动训练进行早期系统康复治疗的疗效。 方法:选取30例肘关节内骨折患者为研究对象,均行切开复位内固定术治疗;随机选取15例于术后应用等速运动训练进行系统康复治疗,术后第4—5天,开始在无痛范围内行患肘等速持续被动运动,每天30min;术后第7—10天时,每天加做10—20min等速肌力训练;术后第12—14天,上午行30min等速持续被动运动改善关节活动度,下午行30min等速肌力训练,每周4d,2周1个疗程,共训练3个疗程。随机选取15例为对照组,术后在医师指导下行功能康复训练,术后第4—5天,在无痛范围内用手法行患肘被动活动,每天30min;术后第7—10天,加做10—20min渐进性阻力训练,术后第12—14天,上午行30min肘关节松动术,下午行30min渐进性阻力训练,每周4d,2周1疗程,共训练3个疗程,最终术后第6个月13例获得随访。 结果:28例患者获得第6个月的随访;两组患者Mayo肘关节功能评分明显增加(P<0.05)和肘关节屈、伸、旋前及旋后活动度均明显改善(P<0.05)。术后第4周、第8周,等速组Mayo评分及肘关节活动度明显优于对照组(P<0.05);术后第6个月,两组康复治疗有效率均为100%;等速康复治疗组患者均未出现内固定物松动、骨折不愈合、废用性骨质疏松的征象。 结论:肘关节内骨折术后患者应用等速运动装置进行早期康复治疗,可明显改善肘关节功能,加快康复进程;等速测试在康复训练过程中可以提供客观、准确数据以供制定更合理、个性化的康复训练模式;等速训练具有很好的安全性,对肢体功能恢复很有效。
关键词:等速运动  肘关节  康复  骨折内固定术
The effect of isokinetic exercise in early rehabilitation of elbow fracture postoperation    Download Fulltext
Qingdao University Medical College, Qingdao,266071
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Abstract:
      Abstract Objective:To explore the effect of early systematic rehabilitation with isokinetic exercise device for patients with elbow fracture postoperation. Method:Thirty patients with elbow fractures underwent open reduction and internal fixation. Fifteen cases were selected randomly and treated with early systematic rehabilitation by using isokinetic exercise device. The training schedule was as follows from the 4th—5th d postoperation isokinetic continuous passive motion with painless strength was applied for 30min every day; from the 7th—10th postoperation isokinetic strength training was added for 10 to 20min daily; from the 12th—14th d postoperation isokinetic continuous passive motion was applica for 30min every morning, and isokinetic strength training was done for 30min every afternoon, both of which were for proceeded 4d per week, and 2 weeks as a course of treatment, 3 courses of treatment in all. The other 15 cases were randomly selected as control group. Then control group took functional rehabilitation exercises under the guidance of physician, from the 4th—5th postoperation elbow passive activity was applied for 30min daily from the 7th—10th postoperation progressive resistance training was added for 10 to 20min daily, from the 12th—14th postoperation elbow mobilization was applied for 30min every morning and progressive resistance training was done for 30min every afternoon, both of which were proceeded for 4d per week, and 2 weeks as a course of treatment, 3 courses of treatment mall. In the final, 13 cases were followed up at the 6th month. Result:Twenty-eight patients were followed up at the 6th month. Mayo elbow scores and elbow flexion,extension,pronation and supination activities of both groups improved significantly(P<0.05).Mayo scores and elbow joint activities in isokinetic group were significantly better than those in control group(P<0.05) at the 4th week and the 8th week postoperation;the effective vates of two groups were 100% at the 6th month postoperation, the patients in isokinetic rehabilitation group patients had no loosening of internal fixation,fracture unhealing or disuse osteoporosis. Conclusion:The isokinetic exercise device maybe used in early rehabilitation of patients with elbow fracture postoperation, can significantly improve elbow function and accelerate recovery process. The isokinetic tests can provide objective and accurate data for designing more rational and individualized training mode. The isokinetic training possess good security, is very effective for limb function recovery.
Keywords:isokinetic exercise  elbow joint  rehabilitation  internal fixation of fracture
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