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在全膝关节整形术后运动模式生物反训练:随机对照试验

Michael J Bade¹, Cory L Christiansen¹, Joseph A Zeni²

¹University of Colorado Anschutz Medical Campus and Eastern Colorado VA Health Care System, Geriatric Research Education and Clinical Center (GRECC), Aurora, Colorado.

Arthritis care & research

|December 23, 2024

概括

在全膝关节整形术 (TKA) 后的运动训练计划 (MOVE) 并没有改善手术膝关节延伸的时刻. 然而,与标准康复相比,MOVE组在行走过程中表现出较少的逆侧膝盖补偿.

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Last Updated: Jun 4, 2025

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科学领域:

整形外科和运动医学
生物力学生物力学
康复科学康复科学康复科学

背景情况:

经过全膝关节整形术 (TKA) 后,持续的运动补偿,如减少手术峰值膝关节延伸时刻 (pKEM),与较差的恢复有关.
这些补偿也可能加速对侧关节性骨关节炎的进展.
需要有效的康复策略来改善TKA后的运动质量.

研究的目的:

评估运动训练计划 (MOVE) 是否与标准康复相比 (CONTROL) 提高了TKA后的运动质量和恢复.
评估MOVE对手术和逆侧膝关节力学的影响.
为了比较MOVE和CONTROL组之间的功能恢复指标.

主要方法:

一项随机临床试验,涉及138名接受TKA的个人.
参与者被分配到运动训练计划 (MOVE) 或标准康复计划 (CONTROL).
评估包括手术和逆侧顶峰膝盖延伸时刻 (pKEM),功能测试 (6MWT,爬楼梯,30STS,TUG),力量,运动范围和身体活动水平,在手术前,10周和TKA后6个月测量.

主要成果:

在6个月后,在MOVE和CONTROL组之间,在行走期间手术pKEM没有显著差异.
与CONTROL组相比,MOVE组在自我选择的步行速度期间显示出明显较少的反 pKEM.
控制组在10周的时间上表现更好,在定时上去 (TUG) 和30秒坐到站 (30STS) 测试中表现更好,但这些差异在六个月内减少了.

结论:

移动干预并没有改善TKA后的外科pKEM,但在行走时减少了逆侧膝盖补偿.
控制组的更快的初始功能恢复需要进一步调查,以确定它是否反映了改善的手术膝关节功能或更多地依赖相反的四肢补偿.
运动训练在减轻补偿策略方面可能有好处,尽管它对初级手术膝盖力学的影响需要进一步研究.