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膝关节置换术前及术后膝骨关节炎患者的疼痛、跌倒恐惧及爬楼梯能力:6个月随访研究

Pain, fear of falling and stair climbing ability in patients with knee osteoarthritis before and after knee replacement: 6 month follow-up study.

作者信息

Unver Bayram, Ertekin Özge, Karatosun Vasfi

机构信息

School of Physiotherapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey.

Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Sifa University, Izmir, Turkey.

出版信息

J Back Musculoskelet Rehabil. 2014;27(1):77-84. doi: 10.3233/BMR-130422.

DOI:10.3233/BMR-130422
PMID:23948839
Abstract

OBJECTIVES

(1) to evaluate the change in time of pain, stair climbing ability and fear of falling (FOF), (2) to determine the association between pain, stair climbing ability and FOF for patients with knee osteoarthritis (OA) following the knee replacement over the course of six months, (3) and to compare the results with healthy controls in terms of stair climbing ability and FOF.

METHODS

Fifteen female healthy controls and 21 female consecutive subjects who were scheduled to undergo primary bilateral knee replacement for the treatment of knee OA were involved. Pain, stair climbing ability and FOF were assessed with a numerical pain rating scale, Going up and Down Scale (GUDS) and Tampa Scale for Kinesiophobia (TSK) at pre-surgery and discharge. After discharge, patients were asked to answer the outcome measures at 2, 4, 8, 12 and 26 week by phone.

RESULTS

Patients had significantly improvement in the postoperative 26-week scores of pain (p< 0.001), stair ability (p< 0.001), and FOF (p=0.006) compared with the preoperative scores. There was also decreased pain at 4.week, improved stair ability at 8.week, and delayed improvement at FOF in patients. While patients had significantly worse stair ability than controls preoperatively (p< 0.001), the difference was not significant at postoperative 26-week (p=0.561). A positive significant correlation was found between the stair ability, FOF and pain scores (p< 0.001).

CONCLUSION

It would be reasonable to consider that FOF control is potentially useful for preventing severe functional limitation in stair climbing for subsequent knee OA before and early after the surgery.

摘要

目的

(1)评估疼痛时间、爬楼梯能力和跌倒恐惧(FOF)的变化;(2)确定膝关节骨关节炎(OA)患者在膝关节置换术后六个月内疼痛、爬楼梯能力和FOF之间的关联;(3)并在爬楼梯能力和FOF方面将结果与健康对照组进行比较。

方法

纳入15名女性健康对照者和21名连续入选的计划接受初次双侧膝关节置换术治疗膝关节OA的女性受试者。在术前和出院时,采用数字疼痛评分量表、上下楼梯量表(GUDS)和坦帕运动恐惧量表(TSK)评估疼痛、爬楼梯能力和FOF。出院后,要求患者在第2、4、8、12和26周通过电话回答结局指标。

结果

与术前评分相比,患者术后26周的疼痛评分(p<0.001)、楼梯能力评分(p<0.001)和FOF评分(p=0.006)有显著改善。患者在术后4周疼痛减轻,8周楼梯能力改善,FOF改善延迟。虽然患者术前楼梯能力明显比对照组差(p<0.001),但术后26周差异不显著(p=0.561)。发现楼梯能力、FOF和疼痛评分之间存在显著正相关(p<0.001)。

结论

可以合理地认为,控制FOF可能有助于预防膝关节OA患者在手术前和术后早期爬楼梯时出现严重的功能受限。

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