足内在肌强化训练对全膝关节置换术后膝关节功能的影响

关键词：全膝关节置换术  足内在肌训练  步态分析  膝骨关节炎  康复

Keywords:total knee arthroplasty  foot intrinsic muscle training  gait analysis  knee osteoarthritis  rehabilitation

摘要：

      摘要 目的：探究足内在肌强化训练对全膝关节置换术（TKA）后患者膝关节功能及步态的影响。 方法：将参与研究的膝骨关节炎患者随机分为研究组与对照组，每组41例。对照组患者TKA后接受膝关节系统康复治疗，研究组在系统康复治疗的基础上增加足内在肌强化训练。在TKA术前及术后第12周分别采用骨关节炎指数评分（WOMAC）及膝关节活动度评估肢体功能、采用Berg平衡量表（BBS评分）及跌倒效能量表（MFES）评估平衡功能、采用便携式智能化步态分析设备进行步态分析。 结果：接受康复治疗12周后，研究组患者在MFES评分、BBS评分及WOMAC评分上优于对照组（P＜0.05），且研究组手术侧肢体单腿支撑时间、步速、步长较对照组有明显改善（P＜0.05）。 结论：TKA术后12周足内在肌强化训练可以改善患者身体功能、平衡能力和步态。

Abstract:

      Abstract Objective： To explore the effects of foot intrinsic muscle strengthening training on knee function and gait in patients after total knee arthroplasty (TKA). Method： Eighty-two patients with unilateral severe knee osteoarthritis were randomly divided into treatment group(n=41) and control group(n=41). The control group received routine rehabilitation treatment after knee replacement， while the treatment group received additional foot intrinsic muscle strengthening exercises alongside standard rehabilitation. Functional outcomes were evaluated preoperatively and at 12 weeks postoperatively using the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC). Balance function was assessed using the Berg Balance Scale(BBS) and the Modified Falls Efficacy Scale(MFES). Gait analysis was performed using portable intelligent gait analysis equipment. Result： After 12 weeks of rehabilitation, the study group showed significantly better outcomes in WOMAC scores，MFES scores and BBS than those in the control group(P<0.05).The single leg support time，step speed and step length of the operative limb in the treatment group were significantly improved compared with the control group(P<0.05). Conclusion：Twelve weeks of foot intrinsic muscle strengthening exercises post-TKA can improve physical function, balance ability, and gait in patients.