924
·临床研究·
Chinese Jburndl of Rehabilitartion Medicine, Oct. 2008, Vol. 23, No.10
早期大角度被动ROM练习对全膝置换术后
膝关节功能的影响
江海燕丨袁巍！
摘要
目的：观察全滕置换术(TKA)后早期大角度膝关节被动活动度（ROM)练习与常规被动ROM练习对TKA后
关节功能改善的影响。方法；将34例老年骨性关节炎(OA)患者按手术顺序随机分成术后常规被动ROM练习组和大角度被动ROM练习组。所有患者均由同一术者用微创全膝置换术式(MIS-TKA)进行手术。大角度被动ROM组在术后2周内的被动ROM练习角度比常规被动ROM练习组大20°—30°，其他康复方案和术后镇痛方案均相同。结果：两组患者术前HSS评分差异无显著性，但术后第1、2、6、12和24周大角度被动ROM练习组的HSS评分均高于常规被动R0M练习组。其中，术后第1、2周的HSS差异有显著性（P<0.05)。两组患者的术前膝关节主动和被动 ROM差异均无显著性，但术后第4天、1周、2周、6周、12周、24周膝的主动和被动ROM差异均有显著性意义（P< 0.05)。结论：对MIS-TKA者术后早期大角度被动ROM练习不仅能改善患膝的主动和被动ROM，还能改善膝HSS
功能评分。关键词
微创全膝置换：关节活动度；康复
中图分类号：R493,R684
文献标识码：A
文章编号：1001-1242(2008)-10-0924-04
Comparative study on the influence of routine passive ROM exercises and early large-angle passive ROM
exercises
on
the
knee
function
post
TKA/JIANG
Rehabilitation Medicine, 2008, 23(10): 924—927
Abstract
YUAN
Haiyan,
Wei,etalJ/Chinese
of
Journal
Objective: To investigate the influence of early largeangle passive ROM exercises or routine passive
ROM exercises on patients' knee function post TKA. Method: Thirtyfour old osteoarthritis (OA) patients post TKA
ROM
passive
included in
routine
operation were
exercises
group and early
large angle passive ROM exercises
group, optionally by operating date at random, seventeen patients in each
group.
were done by one operator with the MISTKA technique.
The operations of all the cases
Within 2 weeks post operation, the angle of passive ROM
sasee
more than that in routine passive ROM
same in both groups.
.Result: The HSS seores pre-
exercises group. The other rehabilitation procedures
the
were
, Post MISTKA operation 1 week, 2 weeks, 6 weeks, 12
operation had no significant difference between 2 groups.
weeks and 24 weeks, the HSS scores in largeangle passive ROM exercises group was higher than that in routine
The HSS
passive ROM exercises group.
were significant higher in large-angle passive ROM exercises group
Sscores
active ROM and passive ROM of operated knee pre-operation
1 week and 2 weeks post MIS-
TKA (P<0.05).
The
But 4 days, 1 week, 2 weeks, 6 weeks, 12 wecks and 24
showed no significant difference between 2 groups.
weeks post MISTKA, the active and passive ROM in early largeangle exercises group was significant higher (P< 0.05). Conclusion: For MISTKA patients, early large-angle passive ROM exercises could not only improve the active and passive ROM, but could improve the HSS knee functional scores also.
on sdoa a oaaee ene so Key words minimally invasive surgerytotal knee arthroplasty; range of motion; rehabilitation
关节软骨损伤后，若得不到有效处理，最终会发展为骨性关节炎（osteoarthritis，OA），致关节功能丧失-},从而严重影响患者的日常生活、学习和工作。因为滕关节的过度使用和创伤等因素，许多老年人的膝关节最后会出现严重的骨性关节炎并需要全膝置换(totalknee arthroplasty，TKA)用。本临床研究通过观察TKA术后早期大角度被动膝关节活动度(rangeofmotion，ROM)练习和常规被动ROM练习
对膝关节功能恢复情况的影响，了解早期大角度 ROM练习对患者TKA术后膝关节功能恢复的意义。
1
资料与方法
北京大学人民医院针灸理疗科，北京，100044
作者简介：江海蒸，女，主管技师收稿日期：200807-15