是否有可能训练患者限制下肢的负重?

Is it possible to train patients to limit weight bearing on a lower extremity?

作者信息

Hustedt Joshua W, Blizzard Daniel J, Baumgaertner Michael R, Leslie Michael P, Grauer Jonathan N

机构信息

Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut 06520, USA.

出版信息

Orthopedics. 2012 Jan 16;35(1):e31-7. doi: 10.3928/01477447-20111122-14.

Abstract

Orthopedic patients are often instructed on how much weight to bear on an injured or postoperative extremity. Although specific weight-bearing instructions are given to a majority of lower-extremity orthopedic patients, the ability of patients to comply with these instructions is questioned in the medical literature. This study compared the effectiveness of new forms of clinical interventions designed to train patients on weight bearing, focusing on the use of biofeedback devices designed to offer real-time feedback to partial weight-bearing patients. Twenty healthy patients aged 20 to 30 years completed 3 interventions: (1) verbal instructions on weight bearing, (2) training with a bathroom scale, and (3) training with a biofeedback device.Patients given touchdown weight-bearing instructions (25 lb) initially bore an average of 63.57±6.24 lb when given verbal instructions. This was reduced to 44.75±5.69 lb after training with a bathroom scale (P<.001), and was further reduced to 26.2±1.57 lb with biofeedback training (P=.011). Likewise, patients given partial weight-bearing instructions (75 lb) initially bore an average of 92.28±7.85 lb. No improvement occurred with the use of a bathroom scale (at 75 lb), which showed an average of 90.82±7.19 lb (P=1.000). Training with a biofeedback device improved the average weight bearing to 69.67±3.18 lb (P=.014).Biofeedback training led to superior compliance with touchdown and partial weight-bearing instructions. Because partial weight-bearing instructions are commonly given to orthopedic patients, training with such a device may be appropriately considered.

摘要

骨科患者常常会得到关于受伤或术后肢体应承受多少重量的指示。尽管大多数下肢骨科患者都收到了具体的负重指示,但医学文献中对患者遵守这些指示的能力提出了质疑。本研究比较了旨在训练患者负重的新型临床干预措施的有效性,重点是使用旨在为部分负重患者提供实时反馈的生物反馈设备。20名年龄在20至30岁之间的健康患者完成了3项干预措施:(1)关于负重的口头指示,(2)使用体重秤进行训练,以及(3)使用生物反馈设备进行训练。接受触地负重指示(25磅)的患者在接受口头指示时,最初平均承受63.57±6.24磅。在使用体重秤训练后,这一重量降至44.75±5.69磅(P<0.001),而通过生物反馈训练进一步降至26.2±1.57磅(P=0.011)。同样,接受部分负重指示(75磅)的患者最初平均承受92.28±7.85磅。使用体重秤(75磅时)没有改善,平均为90.82±7.19磅(P=1.000)。使用生物反馈设备进行训练使平均负重提高到69.67±3.18磅(P=0.014)。生物反馈训练导致对触地和部分负重指示的更好遵守。由于部分负重指示通常给予骨科患者,因此可以适当考虑使用这种设备进行训练。

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