全膝关节置换术患者术前运动:一项随机对照试验。

IF 2.1 Q1 REHABILITATION Archives of physiotherapy Pub Date : 2020-08-05 eCollection Date: 2020-01-01 DOI:10.1186/s40945-020-00085-9
Pascale Gränicher, Thomas Stöggl, Sandro F Fucentese, Rolf Adelsberger, Jaap Swanenburg
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引用次数: 11

摘要

背景:本研究的目的是评估术前物理治疗(PT)对全膝关节置换术(TKA)后功能、主观和社会经济参数的影响。方法:选取2016年7月至2017年3月在Balgrist大学医院计划行TKA的患者20例(平均±SD:年龄67±7岁),随机分为对照组(CG)和干预组(IG)。手术前3至4周,IG完成5至9次PT,包括本体感觉神经肌肉促进(PNF)技术、耐力训练和个别指示的干预措施。测量分别在基线、术前和TKA后3个月进行。主要结果测量是爬楼梯测试(SCT),次要结果测量是膝关节活动范围(ROM)和使用Lysholm评分(LS)和Tegner活动量表(TAS)的身体活动水平。主观和社会经济参数包括患者的整体变化印象(PGIC)量表、住院康复时间、术前疼痛水平和代谢当量(MET)、术后镇痛药的摄入量和总成本。结果:IG与CG对SCT无显著性差异(F (2/36) = 0.016, p = 0.984, η2 = 0.004)。TAS组与时间之间存在交互作用(F (18/1) = 13.890), IG增加(p = 0.002, η2 = 0.536)。LS分项“疼痛”在CG组表现出较高的疼痛水平(F (18/1) = 4.490, p = 0.048, η2 = 0.974),而IG组表现出较高的术前MET (p = 0.035)。没有其他显著的变化。CG组的总成本比IG组高21.4%,使用的镇痛药更多,术前疼痛程度也更高。结论:研究结果表明术前治疗提高了TKA前后的身体活动水平,并导致临床相关的TAS增加。试验注册:ClinicalTrials.gov;NCT03160534。2017年5月19日注册。
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Preoperative exercise in patients undergoing total knee arthroplasty: a pilot randomized controlled trial.

Background: The purpose of this study was to assess the effect of preoperative physiotherapy (PT) on functional, subjective and socio-economic parameters after total knee arthroplasty (TKA).

Methods: 20 patients (mean ± SD: age 67 ± 7 years) scheduled for TKA at Balgrist University Hospital between July 2016 and March 2017 were randomly assigned to a control (CG) or intervention (IG) group. 3 to 4 weeks prior to surgery the IG completed 5 to 9 sessions of PT containing proprioceptive neuromuscular facilitation (PNF) techniques, endurance training and individually indicated interventions. Measurements were executed at baseline, preoperative and 3 months after TKA. The primary outcome measure was the Stair Climbing Test (SCT), secondary outcome measures were the knee range of motion (ROM) and the level of physical activity using Lysholm Score (LS) and Tegner Activity Scale (TAS). The subjective and socio-economic parameters were the Patients' Global Impression of Change (PGIC) scale, inpatient rehabilitation time, preoperative pain levels and metabolic equivalent (MET), postoperative intake of analgesics and overall costs.

Results: No difference between IG and CG was found for SCT (F (2/36) = 0.016, p = 0.984, η2 = 0.004). An interaction between group and time was shown for TAS (F (18/1) = 13.890) with an increase in the IG (p = 0.002, η2 = 0.536). The sub-item "pain" within the LS presented a higher pain-level in CG (F (18/1) = 4.490, p = 0.048, η2 = 0.974), while IG showed a higher preoperative MET compared to CG (p = 0.035). There were no other significant changes. The CG produced 21.4% higher overall costs, took more analgesics and showed higher preoperative pain levels than the IG.

Conclusions: Findings show that preoperative therapy improved the level of physical activity before and after TKA and resulted in a clinically relevant gain in TAS.

Trial registration: ClinicalTrials.gov Identifier; NCT03160534. Registered 19 May 2017.

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