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汪 伍,潘惠娟,王惠芳.关节松动术联合肌力训练在髌股关节炎关节镜术后康复中的应用研究[J].中国康复医学杂志,2016,(3):280~285
关节松动术联合肌力训练在髌股关节炎关节镜术后康复中的应用研究    点此下载全文
汪 伍  潘惠娟  王惠芳
同济大学附属上海市东方医院康复医学科,上海,200120
基金项目:上海市残疾人联合会康复科研课题(K2012031)
DOI:
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摘要:
      摘要 目的:观察关节松动术联合肌力训练对髌股关节炎(patellofemoral osteoarthritis, PFOA)关节镜清理术后的治疗效果。 方法:选取膝关节髌股关节炎关节镜下清理术后患者60例。分组:每组各30例,对照组(A组):行术后常规膝关节活动度和肌力训练;治疗组(B组):除对照组常规治疗外,强化髌股关节松动联合末端伸膝力量和稳定性训练。分别在治疗前及治疗后1、3、6个月时进行Lysholm评分、简易McGill疼痛评分、髌骨活动度测试,髌骨上缘5cm、10cm、15cm处肌肉围度测定取平均值,并采集股内侧肌、股外侧肌表面肌电(sEMG)值,经标准化处理后取均方根值(RMS)为观察指标,进行统计学分析。 结果:术后治疗1个月后,A组Lysholm评分、简易McGill疼痛评分、髌骨活动度明显优于术前,肌肉围度平均值和RMS值差于术前;术后3个月均优于术后1个月,术后6个月与术后3个月比较无明显差异性。治疗1个月后,B组Lysholm评分、简易McGill疼痛评分、髌骨活动度明显优于术前,肌肉围度平均值和RMS值差于术前;术后3个月优于术后1个月,术后6个月明显优于术后3个月。A、B两组术后3个月、6个月组间比较差异有显著性意义(P<0.01),B组明显优于A组。 结论:针对髌股关节炎患者的特点,设计科学、安全、有效的术后康复计划,可以明显促进膝关节功能的康复。
关键词:髌股关节炎  关节松动  关节镜  康复  表面肌电
Application research on joint mobilization combined with muscle strengthened training for rehabilitation after arthroscopic debridement for patellofemoral osteoarthritis    Download Fulltext
Dept. of Rehabilitation Medicine, Shanghai, East Hospital, 200120
Fund Project:
Abstract:
      Abstract Objective: To observe the curative effect of mobilization combined with muscle strengthened training for rehabilitation after arthroscopic debridement for patellofemoral osteoarthritis. Method: Sixty patients with arthroscopic debridement for patellofemoral osteoarthritis were divided randomly into two groups: control group (A),received conventional training for ROM; treatment group (B), in addition to group A's conventional training,received strengthened patellofemoral joint mobilization, combined with trainings of end of knee extension strength and stability. Lysholm score, McGill score and ROM of patella were used to evaluate before operation as well as at the 1st, the 3rd and the 6th month after operation. The muscle circumferences at 5cm/10cm/15cm to the upper edge of the patella were averaged, and the surface EMG(sEMG) for vastus medialis and vastus lateralis were collected and standardized to get the root mean square(RMS) value as observation indexes, then statistical analysis was completed. Result: After 1 month treatment, group A had convincing better results in Lysholm score, McGill score and ROM of patella, comparing with before. The average muscle circumferences and RMS of sEMG were lower. Status in all aspects were better at the 3rd month than those at the 1st month after operation, no obvious difference at the 6th month. Group B had similar results, but the status in all aspects were better at the 6th month than those at the 3rd month. The comparison between groups A and B at the 3rd month and the 6th month after operation had significant difference (P<0.01). The effect of group B was obviously better than that of group A. Conclusion: A scientific, safe and effective rehabilitation plan was designed according to the features of patients with patellofemoral osteoarthritis after arthroscopic debridement. The systematic joint mobilization combined with muscle strengthened training for patients after operation can significantly improve the recovery of knee joint functions.
Keywords:patellofemoral osteoarthritis  joint mobilization  arthroscopic  rehabilitation  surface electromyography
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