减重支持训练对前交叉韧带重建术后患者动态足底压力的影响

关键词：减重支持训练  前交叉韧带重建  足底压力  步行训练

Keywords:partial body weight support training  anterior cruciate ligament reconstruction  plantar pressure  walking training

摘要：

      摘要 目的：观察减重支持（partial body weight support，PBWS）训练对前交叉韧带（anterior cruciate ligament， ACL）重建术后患者动态足底压力的影响。 方法：采用随机数字表法将35例符合纳入排除标准的ACL重建术后患者随机分为观察组17例和对照组18例。两组患者术后第1天均给予常规基础康复训练；术后第2周起，对照组进行常规步行训练，观察组进行PBWS步行训练。步行训练前、治疗5周后分别检测两组患者足底平均峰值压强（max pressure，MP）、足底峰值压强（peak pressure，PP）、足底总平均峰值压力(sum max force， SMF)和足底各区域平均峰值压力（max force，MF）。 结果：与治疗前比，治疗5周后两组患者MP、PP、SMF和各区域MF均有显著提高（P<0.05）。治疗5周后与对照组比，观察组MP[（2.84±0.83）N/cm2]、PP[（12.36±3.39）N/cm2]和SMF[（690.50±141.41）N]均优于对照组水平（P<0.05），进一步分析足底各区域MF发现，观察组MFF3区[（14.89±5.55）N]、MFF5区[（152.25±26.73）N]、MFR3区[（125.74±20.35）N]和MFR2区[（201.42±37.29）N]改善幅度优于对照组水平（P<0.05），而足底其余区域MF改善幅度无显著性意义（P>0.05）。 结论：PBWS训练联合常规基础康复训练优于常规步行训练联合常规康复训练，可提高ACL重建术后患者患肢动态足底峰值压力和压强水平，并有利于足底各区域负荷模式正常化。

Abstract:

      Abstract Objective：To observe the effect of partial body weight support （PBWS） training on dynamic plantar pressure in patients with ACL reconstruction. Method：Totally 35 ACL reconstruction patients were randomly divided into observation group (n=17) and control group (n=18). Both groups took basic rehabilitation treatment. From 2 weeks after surgery，the control group was given conventional gait training， and the observation group was given PBWS gait training. MP，PP，SMF and MF were measured before and after 5 weeks training. Result：Compared with before training， MP， PP， SMF and MF were significantly improved in both groups (P<0.05) after 5 weeks training. MP [(2.84±0.83)N/cm2]， PP [(12.36±3.39)N/cm2] and SMF [(690.50±141.41)N] in the observation group were better than the control group (P<0.05). We further analyzed the MF in each area and found that the improvement of MFF3 area [(14.89±5.55)N]， MFF5 [(152.25±26.73)N)]， MFR3[125.74±20.35)N] and MFR2[(201.42±37.29)N] in the observation group was better than that of the control group (P<0.05)， but the improvement of MF in other areas were not significant (P>0.05). Conclusion：PBWS training combined with basic rehabilitation treatment is superior to conventional gait training combined with basic rehabilitation treatment， which can effectively improve the dynamic plantar pressure and increase the weight-bearing capacity of patients after ACL reconstruction，and help to develop the correct weight-bearing mode.