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两种术后康复方案对前交叉韧带重建后长期影响的随机对照临床试验:2 年随访结果

The long-term effect of 2 postoperative rehabilitation programs after anterior cruciate ligament reconstruction: a randomized controlled clinical trial with 2 years of follow-up.

机构信息

NAR, Orthopedic Center, Oslo University Hospital, Ullevaal, Oslo, Norway.

出版信息

Am J Sports Med. 2009 Oct;37(10):1958-66. doi: 10.1177/0363546509335196. Epub 2009 Jun 25.

Abstract

BACKGROUND

There is no consensus regarding the optimal postoperative rehabilitation program after anterior cruciate ligament (ACL) reconstruction.

PURPOSE

The purpose of this study was to examine the long-term outcome of a 6-month neuromuscular exercise (NE) training program versus a traditional strength exercise (SE) training program after ACL reconstruction.

STUDY DESIGN

Randomized controlled trial; Level of evidence, 1.

METHODS

Seventy-four patients were randomly assigned to either a NE program or a SE program and tested preoperatively and at 6 months, 1 year, and 2 years after ACL reconstruction. Outcome measurements were as follows: Cincinnati knee score, visual analog scale for pain and global function, Short Form 36, functional knee tests, and isokinetic muscle strength tests.

RESULTS

There were no significant differences between the NE and SE programs 1 and 2 years after ACL reconstruction for the primary outcome measurement (Cincinnati knee score). There were significantly improved knee function (global function) and reduced pain during activity for the NE group, compared with the SE group, and significantly improved hamstring muscle strength for the SE group, compared with the NE group, 2 years after ACL reconstruction.

CONCLUSION

On the basis of these results, a postoperative program combining both NE and SE should be included after ACL reconstruction to improve knee function.

摘要

背景

对于前交叉韧带(ACL)重建术后的最佳康复方案,目前尚未达成共识。

目的

本研究旨在探讨 ACL 重建术后 6 个月神经肌肉训练(NE)与传统力量训练(SE)的长期疗效。

研究设计

随机对照试验;证据水平,1 级。

方法

74 例患者随机分为 NE 组或 SE 组,分别在 ACL 重建术前和术后 6 个月、1 年和 2 年进行测试。主要评估指标包括:辛辛那提膝关节评分、疼痛和整体功能的视觉模拟量表、SF-36 量表、膝关节功能测试和等速肌力测试。

结果

ACL 重建后 1 年和 2 年,NE 组与 SE 组在主要结局测量(辛辛那提膝关节评分)方面无显著差异。与 SE 组相比,NE 组在术后 2 年时膝关节功能(整体功能)明显改善,活动时疼痛减轻,而 SE 组的腘绳肌力量明显增强。

结论

基于这些结果,ACL 重建术后应采用包含 NE 和 SE 的综合康复方案以改善膝关节功能。

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