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全膝关节置换术后坐站转移时的负重不对称与功能障碍和功能移动性相关。

Weight-bearing asymmetry during sit-stand transitions related to impairment and functional mobility after total knee arthroplasty.

机构信息

Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, USA.

出版信息

Arch Phys Med Rehabil. 2011 Oct;92(10):1624-9. doi: 10.1016/j.apmr.2011.05.010. Epub 2011 Aug 12.

Abstract

OBJECTIVES

To examine changes in weight-bearing (WB) asymmetry during sit-stand transitions for individuals during the first 6 months after unilateral total knee arthroplasty (TKA). Relationships between WB asymmetry, clinical measures of knee impairment, and functional mobility also were evaluated.

DESIGN

Prospective repeated-measures design.

SETTING

Clinical research laboratory.

PARTICIPANTS

People (N=36) with knee osteoarthritis (OA) scheduled to undergo unilateral TKA and a control (CTL) group (N=17 healthy people) were enrolled.

INTERVENTION

The TKA group participated in acute, home, and outpatient phases of exercise-based rehabilitation.

MAIN OUTCOME MEASURES

WB asymmetry measured during a 5-Times Sit-to-Stand Test (FTSST) based on average vertical ground reaction force under each foot, self-reported knee pain using a numerical pain rating scale, knee active range of motion symmetry, knee extensor strength symmetry, FTSST time, 6-minute walk test distance, and Stair Climbing Test time.

RESULTS

Compared with preoperative values, the TKA group showed greater WB asymmetry at 1 month after surgery (P<.001). By 6 months, the TKA group had less WB asymmetry than preoperative values (P<.001), which was not different from the CTL group. Symmetry in WB correlated with functional outcomes and symmetry of quadriceps strength for the TKA group 6 months postoperatively.

CONCLUSIONS

Patients with unilateral knee OA showed WB asymmetry during sit-stand transitions early after unilateral TKA that improved by 6 months after surgery and was no different from that for healthy people of similar age. For people in the first 6 months after TKA, greater symmetry was related to better function and strength symmetry.

摘要

目的

研究单侧全膝关节置换术(TKA)后 6 个月内个体在坐站转换过程中负重(WB)不对称性的变化。还评估了 WB 不对称性与膝关节损伤的临床测量指标和功能性移动性之间的关系。

设计

前瞻性重复测量设计。

设置

临床研究实验室。

参与者

招募了患有膝骨关节炎(OA)并计划接受单侧 TKA 的人群(TKA 组,N=36)和对照组(CTL 组,健康人群,N=17)。

干预

TKA 组参加了基于急性、家庭和门诊的锻炼为基础的康复。

主要观察指标

基于每个脚的平均垂直地面反作用力的 5 次坐-站测试(FTSST)中的 WB 不对称性、使用数字疼痛评分量表报告的膝关节疼痛、膝关节主动活动范围的对称性、膝关节伸肌力量的对称性、FTSST 时间、6 分钟步行测试距离和爬楼梯测试时间。

结果

与术前值相比,TKA 组术后 1 个月时 WB 不对称性更大(P<.001)。到 6 个月时,TKA 组的 WB 不对称性比术前值小(P<.001),与 CTL 组无差异。术后 6 个月,TKA 组的 WB 对称性与功能性结果和股四头肌力量的对称性相关。

结论

单侧膝 OA 患者在单侧 TKA 后早期进行坐站转换时表现出 WB 不对称性,这种情况在术后 6 个月时得到改善,与年龄相似的健康人群无差异。对于 TKA 后 6 个月内的人群,更大的对称性与更好的功能和力量对称性相关。

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