Liao Chun-de, Huang Yi-Ching, Lin Li-Fong, Huang Shih-Wei, Liou Tsan-Hon
Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
Arthritis Care Res (Hoboken). 2015 May;67(6):799-808. doi: 10.1002/acr.22474.
Obesity is associated with an increased risk of osteoarthritis, and the incidence of obese patients requiring a total knee replacement (TKR) has increased in recent years. A high body mass index (BMI) may influence post-TKR rehabilitation outcomes. We investigated the effects of obesity on functional mobility outcomes following post-TKR rehabilitation in Asian patients whose BMIs were not as high as those reported in similar studies performed in non-Asian countries.
A total of 113 patients were categorized as normal weight (n = 23), overweight (n = 32), class I obese (n = 31), or class II/III obese (n = 27). Patients were retrospectively followed up for 6 months after undergoing TKR followed by 2 months of active rehabilitation. Outcome measures were recorded at baseline and at the 2-month and 6-month followup assessments and included the Western Ontario and McMaster Universities Osteoarthritis Index and the following tests: functional reach, single-leg stance, ten-meter walk, timed up and go, chair rise, and stair climbing.
A 4 × 3 (group × time) repeated-measures analysis of variance showed significant improvement in all of the outcome measures for all of the BMI groups at the 2-month and 6-month followup assessments (P < 0.05 for all). No significant intergroup differences at the 2-month and 6-month followup assessments were observed for any of the mobility measures except the functional reach and single-leg stance (P < 0.05).
Patients with class II/III obesity benefit from early post-TKR outpatient rehabilitation and respond as well as patients with lower BMIs.
肥胖与骨关节炎风险增加相关，近年来需要进行全膝关节置换术（TKR）的肥胖患者发病率有所上升。高体重指数（BMI）可能会影响TKR术后的康复效果。我们调查了肥胖对亚洲患者TKR术后康复功能活动结果的影响，这些亚洲患者的BMI不像在非亚洲国家进行的类似研究中报告的那么高。
总共113例患者被分类为正常体重（n = 23）、超重（n = 32）、I类肥胖（n = 31）或II/III类肥胖（n = 27）。患者在接受TKR后进行回顾性随访6个月，随后进行2个月的积极康复。在基线以及2个月和6个月的随访评估中记录结果指标，包括西安大略和麦克马斯特大学骨关节炎指数以及以下测试：功能性伸展、单腿站立、十米步行、定时起立行走、从椅子上站起和爬楼梯。
4×3（组×时间）重复测量方差分析显示，在2个月和6个月的随访评估中，所有BMI组的所有结果指标均有显著改善（所有P < 0.05）。除功能性伸展和单腿站立外，在2个月和6个月的随访评估中，任何活动度测量指标均未观察到显著的组间差异（P < 0.05）。
II/III类肥胖患者从TKR术后早期门诊康复中获益，并且与较低BMI的患者反应相同。
