膝关节病患者术前和术后运动本体感受能力的比较。

Zeitschrift fur Orthopadie und Unfallchirurgie Pub Date : 2024-10-01 Epub Date: 2023-10-05 DOI:10.1055/a-2151-4849
Viktoria Schröter, Clemens Könczöl, Jens O Anders
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引用次数: 0

摘要

外科医生和患者都希望在膝关节TEP手术后的短时间内获得高水平的满意度和尽可能好的功能结果。通过使用一种工具,在移动的基础上,以数字方式记录术前和术后平衡和运动功能的各种测量参数,并且只需很少的时间,就可以比较渐进的结果。因此,可以确定个体因素,这些因素可以影响再生和训练的进展。在一项前瞻性研究中,对100名患者在安装水泥保留膝关节TEP之前和66名患者进行了以下参数的评估:平衡、最大强度和力量。所有测量均使用MotoSana的KMP测量平台进行。在标准化的随访治疗后,对每个病例进行第二次测量。研究表明,年龄、身高、体重等个人因素与基线值和表现指标(最大力量和力量)之间存在显著关系。此外,研究表明,术后的改善在很大程度上可以通过平衡支撑来实现。所有以前必须用一只手或两只手坚持的患者在手术后不再需要支撑,以在15 s的指定时间内保持单腿姿势。为了对平衡参数进行更详细的分析,对样本进行了调整,只对术前和术后没有坚持支持的患者进行了计数。在初始姿势较低和中等的患者中,摇摆区域在第二次测量时增加,在摇摆区域较大的患者中减少,姿势变得更加稳定。在最大力量和力量方面,与其他患者相比,基线值较高的患者在AHB后仍然具有较高的值,但与他们自己的基线值相比具有较低的值。与较弱的组相比,在手术前已经有很好运动技能的患者能够在运动技能方面获得更大的提高。然而,所有患者在完成AHB后均未能达到术前基线值。在所有组中仍然可以检测到平衡缺陷。通过使用所提出的力板,可以在AHB期间和之后进行基于测量的协调康复程序。通过个性化改善平衡和运动功能的康复有望防止膝关节置换术后的不满,例如由于股髌疼痛综合征中的肌肉失衡。
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Comparison of Pre- and Postoperative Motor-proprioceptive Abilities in Patients with Gonarthrosis.

Both surgeons and patients want to achieve a high level of satisfaction and the best possible functional results within a short time after knee TEP surgery. By using a tool that digitally records various measurement parameters of balance and motor function preoperatively and postoperatively on a mobile basis and with little time expenditure, progressive results can be compared. Individual factors can thus be determined and these can influence the progress in regeneration and training progress perioperatively.In a prospective study, 100 patients before and 66 patients after installation of a cement-retained knee TEP were evaluated for the following parameters: balance, maximum strength, and power. All measurements were performed with the KMP measurement platform from MotoSana. The second measurements were performed in each case after a standardised follow-up treatment.It was shown that there are significant relationships between personal factors such as age, height, body weight and with baseline values and performance measures: maximum strength and power. Furthermore, it was shown that postoperative improvement could be achieved for the most part around balance support. All patients who previously had to hold on with one hand or both hands no longer needed support after surgery to maintain the single-leg stance for the specified time of 15 s. For a more detailed analysis of the balance parameters, the samples were adjusted and only the patients who did not hold on for support pre- and postoperatively were counted. In patients with low and medium initial stance, the sway area increased at the second measurement session, and in patients with large sway areas, it decreased, and the stance became more stable. In the area of maximum strength and power, patients with high baseline values still had higher values after AHB compared with the other patients, but lower values compared with their own baseline values.Patients who already had very good motor skills before surgery were able to achieve a greater increase in motor skills compared to the weaker group. However, all patients failed to reach their preoperative baseline values after completion of the AHB. Deficits in balance were still detectable in all groups. By using the presented force plate, measurement-based coordinated rehabilitation procedures are possible during and after completion of the AHB. Rehabilitation with individualised improvement of balance and motor function could be expected to prevent dissatisfaction after knee arthroplasty, e.g. due to muscular imbalance in femoropatellar pain syndromes.

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