Jenkins Cathy, Barker Karen L, Pandit Hemant, Dodd Christopher A F, Murray David W
Physiotherapy Research Unit, Nuffield Orthopaedic Centre NHS Trust, Headington, Oxford, Oxfordshire OX3 7LD, United Kingdom.
Phys Ther. 2008 Sep;88(9):1012-21. doi: 10.2522/ptj.20070374. Epub 2008 Jul 17.
Kneeling is an important functional activity frequently not performed after knee replacement, thus affecting a patient's ability to carry out basic daily tasks. Despite no clinical reason preventing kneeling, many patients fail to resume this activity. The purpose of this study was to determine whether a single physical therapy intervention would improve patient-reported kneeling ability following partial knee replacement (PKR).
Sixty adults with medial compartment osteoarthritis, suitable for a PKR, participated.
This was a single-blind, prospective randomized controlled trial. Six weeks after PKR, participants randomly received either kneeling advice and education or routine care where no specific kneeling advice was given. Reassessment was at 1 year postoperatively. The primary outcome measure was patient-reported kneeling ability, as assessed by question 7 of the Oxford Knee Score. Other factors associated with kneeling ability were recorded. These factors were scar position, numbness, range of flexion, involvement of other joints, and pain. Statistical analysis included nonparametric tests and binary logistic regression.
A significant improvement in patient-reported kneeling ability was found at 1 year postoperatively in those participants who received the kneeling intervention. Group allocation was the only factor determining an improvement in patient-reported kneeling ability at 1 year postoperatively.
The single factor that predicted patient-reported kneeling ability at 1 year postoperatively was the physical therapy kneeling intervention given at 6 weeks after PKR. The results of this study suggest that advice and instruction in kneeling should form part of a postoperative rehabilitation program after PKR. The results can be applied only to patients following PKR.
跪姿是一项重要的功能活动，但膝关节置换术后患者常常无法进行，从而影响患者执行基本日常任务的能力。尽管没有临床原因阻止患者跪姿，但许多患者仍无法恢复此项活动。本研究的目的是确定单一的物理治疗干预是否能改善全膝关节置换术（PKR）后患者报告的跪姿能力。
60名患有内侧间室骨关节炎且适合进行PKR的成年人参与了研究。
这是一项单盲、前瞻性随机对照试验。PKR术后6周，参与者随机接受跪姿建议与教育或常规护理，常规护理组未给予特定的跪姿建议。术后1年进行重新评估。主要结局指标是患者报告的跪姿能力，通过牛津膝关节评分的问题7进行评估。记录与跪姿能力相关的其他因素。这些因素包括瘢痕位置、麻木、屈曲范围、其他关节受累情况和疼痛。统计分析包括非参数检验和二元逻辑回归。
接受跪姿干预的参与者在术后1年患者报告的跪姿能力有显著改善。分组是术后1年决定患者报告的跪姿能力改善的唯一因素。
术后1年预测患者报告的跪姿能力的单一因素是PKR术后6周给予的物理治疗跪姿干预。本研究结果表明，跪姿建议和指导应成为PKR术后康复计划的一部分。该结果仅适用于PKR术后的患者。
