可穿戴振动反馈训练对前交叉韧带重建术后患者平衡及行走功能的影响

关键词：振动  反馈  前交叉韧带重建  平衡  步态

Keywords:vibration  feedback  anterior cruciate ligament reconstruction  balance  gait

摘要：

      摘要 目的：观察自行研发的可穿戴振动反馈训练系统对前交叉韧带重建术后患者平衡及行走功能的影响。 方法：将符合入选标准的前交叉韧带损伤术后患者50例，随机分为对照组（n=25）与观察组（n=25），两组患者均接受常规的患肢关节松动、肌力训练、神经肌肉电刺激疗法和平衡训练。在此基础上，观察组每日增加1h的可穿戴振动反馈训练，每周5天，对照组在基础治疗上加上每日自行步行训练1h，每周5天。治疗前和治疗8周后，采用膝关节主动角度重现法（active angel repositioning，AAR）、膝关节功能Lysholm评分、Berg量表（Berg balance scale， BBS）、GAITRITE步态分析获得的步幅和步速值和等速运动中角速度为 60°/s时的患侧膝关节屈伸肌群的峰力矩（peak torque， PT）进行评定。 结果：治疗前两组患者的AAR（30°）、AAR（60°）、Lysholm评分、BBS，以及步幅和步速、伸膝PT、屈膝PT差异均无显著性（P>0.05）。治疗8周后，两组患者的Lysholm评分、BBS、步幅和步速、伸膝PT、屈膝PT指标较治疗前均有提高，AAR（30°）和AAR（60°）得分均降低，差异均有显著性意义（P<0.05）。治疗后，观察组的Lysholm[（89.68±8.02）分]、BBS[（54.20±2.60）分]、步幅[（89.64±8.75）cm]、步速[（54.56±5.51）m/min]、伸膝PT[（74.16±8.88）N·m]、屈膝PT[（57.72±5.76）N·m]均显著优于对照组，AAR（30°）（3.57±1.64）、AAR（60°）（3.49±2.07）均显著低于对照组，差异均有显著性意义（P<0.05）。 结论：可穿戴振动反馈训练能够显著提高前交叉韧带重建术后患者平衡及行走功能。

Abstract:

      Abstract Objective： To observe the effect of a self-developed wearable vibration feedback training system on the balance and walking ability of patients after anterior cruciate ligament reconstruction. Method： Fifty patients after anterior cruciate ligament reconstruction（ACLR）who met the selection criteria were randomly divided into control group（n=25） and observation group（n=25）. The control group received routine joint mobilization、muscle strength training、neuromuscular electrical stimulation therapy and balance training，while the observation group received an additional vibration feedback system to the treatment. Patients were allowed to wear for 1 hour a day and 5 days a week for training. Before or 8 weeks after treatment，we used the active angel repositioning （AAR）， knee function Lysholm score，Berg Balance Scale（ BBS），and GAITRITE gait analysis system、peak torque of knee extension and knee flexion at 60°/s to make assessments. Result： Before treatment， there was no significant difference in AAR （30°）， AAR （60°）， Lysholm score， BBS， stride length，velocity， knee extension PT and knee flexion PT between the two groups（P>0.05）. After 8 weeks treatment， the Lysholm score， BBS， stride length， velocity and knee extension PT of the two groups were improved compared with those before treatment，while the AAR （30°） and AAR （60°） were significantly reduced，and the differences were statistically significant （P<0.05）. Conclusion： Wearable vibration feedback training can significantly improve the balance and walking function of patients after anterior cruciate ligament reconstruction.