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膝关节置换术对膝关节感觉运动系统性能的影响。

Impact of knee arthroplasty on knee sensorimotor system performance.

作者信息

Słupik Anna, Kowalski Marcin, Białoszewski Dariusz

机构信息

Division of Rehabilitation, Department of Physiotherapy, 2nd Medical Faculty, Medical University of Warsaw, Poland.

Department of Orthopaedics and Musculoskeletal Traumatology, 1st Medical Faculty, Medical University of Warsaw, Poland.

出版信息

Ortop Traumatol Rehabil. 2013 Nov-Dec;15(6):555-65. doi: 10.5604/15093492.1091511.

DOI:10.5604/15093492.1091511
PMID:24662902
Abstract

BACKGROUND

The study aimed to assess the impact of joint degeneration due to advanced gonarthrosis and the effect of arthroplasty on proprioception and sensorimotor system performance of the knee.

MATERIAL AND METHOD

The arthroplasty group comprised 62 persons, aged 68.8 years on average, who underwent knee replacement due to gonarthrosis. The control group consisted of 74 healthy persons, with an average age of 67.5 years. The participants performed a test of Joint Position Sense (JPS) at 45° flexion and a Sensorimotor Control Test (SCT) designed by the authors to evaluate sensorimotor system performance (on a scale of 0-5). The arthroplasty group was assessed three times: before the knee replacement surgery, and then at 8 and 100 days after the surgery. The control group was assessed once.

RESULTS

The control group scored a mean of 4.9 in the SCT test and 3.9° in the JPS test. The mean scores upon consecutive measurements in the arthroplasty group were 3.1, 2.9 and 4.5 for the SCT test and 10.5°, 9.5° and 3.9° (compared to 8.1° for the healthy limb) for the JPS test.

CONCLUSIONS

  1. Considerable proprioceptive and sensorimotor system performance deficits, as recorded in the arthroplasty group, may contribute to faster progression of degenerative disease and increase the risk of a fall. 2. The Sensorimotor Control Test designed by the authors seems to represent an objective and comprehensive method for assessing the sensorimotor system performance of the knee in gonarthrosis patients. 3. The Sensorimotor Control Test provides a qualitative assessment and may be employed in the clinical therapeutic setting.
摘要

背景

本研究旨在评估晚期膝关节炎所致关节退变的影响以及关节置换术对膝关节本体感觉和感觉运动系统性能的影响。

材料与方法

关节置换术组包括62例平均年龄为68.8岁、因膝关节炎接受膝关节置换的患者。对照组由74例平均年龄为67.5岁的健康人组成。参与者进行了45°屈曲位的关节位置觉(JPS)测试以及作者设计的用于评估感觉运动系统性能的感觉运动控制测试(SCT,评分范围为0 - 5分)。关节置换术组在膝关节置换手术前、术后8天和术后100天进行了三次评估。对照组仅进行了一次评估。

结果

对照组在SCT测试中的平均得分为4.9分,在JPS测试中的平均得分为3.9°。关节置换术组在连续测量中,SCT测试的平均得分分别为3.1分、2.9分和4.5分,JPS测试的得分分别为10.5°、9.5°和3.9°(健侧肢体为8.1°)。

结论

  1. 关节置换术组记录到的明显本体感觉和感觉运动系统性能缺陷可能导致退行性疾病进展更快,并增加跌倒风险。2. 作者设计的感觉运动控制测试似乎是评估膝关节炎患者膝关节感觉运动系统性能的一种客观且全面的方法。3. 感觉运动控制测试提供了一种定性评估,可用于临床治疗环境。

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