Nazzal Mahmoud I, Bashaireh Khaldoon H, Alomari Mahmoud A, Nazzal Mohammad S, Maayah Mikhled F, Mesmar Mohammad
Division of Physical Therapy, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Int J Rehabil Res. 2012 Jun;35(2):94-101. doi: 10.1097/MRR.0b013e32834df63c.
The aim of this study was to examine patient satisfaction with rehabilitation after total knee arthroplasty (TKA). Fifty-six patients, aged 45-77 years, were enrolled in a post-TKA comprehensive therapy program focusing on knee strengthening and functional activities. The program lasted 3 months and was conducted for 1 h, twice a day, 5 days per week. Pain scores, number of steps climbed (STp), and maximum walked distance (MWD) were determined before the operation and 3 months after cessation of the rehabilitation program. In addition, knee-flexion range of motion (ROM) was measured before the surgery and immediately, 2 weeks and 3 months after the surgery. Pain decreased whereas MWD and STp increased at 3 months postoperation. In addition, the magnitude of improvement in STp correlated positively with the magnitude of change in MWD and pain. There was a significant increase in knee-flexion ROM at 2 weeks and 3 months postoperation compared with preoperation. The patient age also correlated positively with the magnitude of improvement in knee-flexion ROM after 2 weeks and 3 months of therapy. Improvements in MWD and STp were greater and pain was less, among the satisfied patients compared with unsatisfied ones. The results of this study further confirm the importance of therapy for osteoarthritis patients after TKA. In addition, as older patients are less conditioned, they seem to be more inclined to improvement in functionality with rehabilitation. Satisfied patients seem to achieve larger improvements in functional capacity and pain measures.
本研究的目的是调查全膝关节置换术(TKA)后患者对康复治疗的满意度。56名年龄在45 - 77岁之间的患者参加了一项TKA后综合治疗项目,该项目侧重于膝关节强化和功能活动。该项目为期3个月,每周进行5天,每天2次,每次1小时。在手术前以及康复项目结束后3个月测定疼痛评分、爬楼梯步数(STp)和最大步行距离(MWD)。此外,在手术前、手术后即刻、2周和3个月时测量膝关节屈曲活动范围(ROM)。术后3个月时疼痛减轻,而MWD和STp增加。此外,STp的改善幅度与MWD和疼痛的变化幅度呈正相关。与术前相比,术后2周和3个月时膝关节屈曲ROM显著增加。患者年龄也与治疗2周和3个月后膝关节屈曲ROM的改善幅度呈正相关。与不满意的患者相比,满意的患者MWD和STp的改善更大,疼痛更小。本研究结果进一步证实了TKA后治疗对骨关节炎患者的重要性。此外,由于老年患者身体条件较差,他们似乎更倾向于通过康复改善功能。满意的患者似乎在功能能力和疼痛指标方面取得了更大的改善。