Musculoskeletal Research Unit, CQ University, PO Box 4045, Rockhampton, QLD 4700, Australia.
Knee Surg Sports Traumatol Arthrosc. 2011 Jul;19(7):1158-67. doi: 10.1007/s00167-010-1386-8. Epub 2011 Jan 26.
The aim of this study was to investigate the outcome after ACL reconstruction between a group of patients receiving a standardized, supervised, physiotherapy-guided rehabilitation programme and a group of patients who followed an unsupervised, home-based rehabilitation programme.
Forty patients with isolated anterior cruciate ligament injuries were allocated to either a supervised physiotherapy intervention group or home-based exercise group. Patients were investigated by an independent examiner pre-operative, 3, 6, 9 and 12 months post-surgery using the following outcome measures: Lysholm Score and Tegner Activity Scale, functional hopping tests, and isometric and isokinetic strength assessments.
Both groups improved significantly (P = 0.01-0.04) following 12 months after surgery. The median Lysholm score increased from 57 (34-90) to 94 (90-100) in the supervised group and 60 (41-87) to 97 (95-100) in the unsupervised group. The median Tegner Activity Scale increased from 3 (2-8) to 6 (3-8) in the supervised group and 4 (2-8) to 5 (3-10) in the unsupervised group. The combined mean symmetry indices for the hopping tests improved from 77.3 ± 18.7 to 86.8 ± 11.1 (supervised) and from 78.1 ± 30.5 to 88.3 ± 10.9 (unsupervised). Isometric and isokinetic strength symmetry indices for knee extension improved from 68.9 ± 23.5 to 82.8 ± 11.9, respectively, 63.7 + 22.8 to 82.7 + 15.1 in the supervised group and from 73.6 ± 20.5 to 76.5 ± 17.9, respectively, 69.5 ± 24.3 to 76.9 ± 16.9 in the unsupervised group. Eccentric strength symmetry indices for knee extension improved from 67.9 ± 27.7 to 87.8 ± 6.8 in the supervised group and from 71.3 ± 17.8 to 82.6 ± 15.6 in the unsupervised group.
This study could not demonstrate a benefit in a rehabilitation programme supervised by a physiotherapist in our population compared to an unsupervised cohort.
本研究旨在调查接受标准化、监督的物理治疗指导康复计划的患者组和接受非监督、家庭为基础的康复计划的患者组之间的 ACL 重建后的结果。
40 名患有孤立性前交叉韧带损伤的患者被分配到监督物理治疗干预组或家庭锻炼组。患者在术前、术后 3、6、9 和 12 个月由独立检查者使用以下结果测量：Lysholm 评分和 Tegner 活动量表、功能性跳跃测试以及等长和等速力量评估。
两组在手术后 12 个月后均有显著改善（P=0.01-0.04）。监督组的 Lysholm 评分中位数从 57（34-90）增加到 94（90-100），而未监督组从 60（41-87）增加到 97（95-100）。监督组的 Tegner 活动量表中位数从 3（2-8）增加到 6（3-8），而未监督组从 4（2-8）增加到 5（3-10）。跳跃测试的合并平均对称性指数从 77.3±18.7 增加到 86.8±11.1（监督）和 78.1±30.5 增加到 88.3±10.9（未监督）。膝关节伸展的等长和等速力量对称性指数分别从 68.9±23.5 增加到 82.8±11.9，从 63.7±22.8 增加到 82.7±15.1，监督组分别从 73.6±20.5 增加到 76.5±17.9，从 69.5±24.3 增加到 76.9±16.9，未监督组。膝关节伸展的离心力量对称性指数从 67.9±27.7 增加到 87.8±6.8，监督组从 71.3±17.8 增加到 82.6±15.6，未监督组。
与非监督队列相比，本研究未能证明在我们的人群中由物理治疗师监督的康复计划有优势。
