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全膝关节置换术后早期康复后的体重指数与功能活动结果:台湾的一项回顾性研究

Body mass index and functional mobility outcome following early rehabilitation after a total knee replacement: a retrospective study in Taiwan.

作者信息

Liao Chun-de, Huang Yi-Ching, Lin Li-Fong, Huang Shih-Wei, Liou Tsan-Hon

机构信息

Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.

National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.

出版信息

Arthritis Care Res (Hoboken). 2015 May;67(6):799-808. doi: 10.1002/acr.22474.

Abstract

OBJECTIVE

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.

METHODS

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.

RESULTS

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).

CONCLUSION

Patients with class II/III obesity benefit from early post-TKR outpatient rehabilitation and respond as well as patients with lower BMIs.

摘要

目的

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。

方法

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。

结果

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)。

结论

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。

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