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前交叉韧带术后康复原则。

Principles of postoperative anterior cruciate ligament rehabilitation.

作者信息

Saka Tolga

机构信息

Tolga Saka, Department of Sports Medicine, Bezmialem Vakif University Medical Faculty Hospital, 34093 Fatih, Istanbul, Turkey.

出版信息

World J Orthop. 2014 Sep 18;5(4):450-9. doi: 10.5312/wjo.v5.i4.450.

Abstract

It is known that anterior cruciate ligament (ACL) reconstruction needs to be combined with detailed postoperative rehabilitation in order for patients to return to their pre-injury activity levels, and that the rehabilitation process is as important as the reconstruction surgery. Literature studies focus on how early in the postoperative ACL rehabilitation period rehabilitation modalities can be initiated. Despite the sheer number of studies on this topic, postoperative ACL rehabilitation protocols have not been standardized yet. Could common, "ossified" knowledge or modalities really prove themselves in the literature? Could questions such as "is postoperative brace use really necessary?", "what are the benefits of early restoration of the range of motion (ROM)?", "to what extent is neuromuscular electrical stimulation (NMES) effective in the protection from muscular atrophy?", "how early can proprioception training and open chain exercises begin?", "should strengthening training start in the immediate postoperative period?" be answered for sure? My aim is to review postoperative brace use, early ROM restoration, NMES, proprioception, open/closed chain exercises and early strengthening, which are common modalities in the very comprehensive theme of postoperative ACL rehabilitation, on the basis of several studies (Level of Evidence 1 and 2) and to present the commonly accepted ways they are presently used. Moreover, I have presented the objectives of postoperative ACL rehabilitation in tables and recent miscellaneous studies in the last chapter of the paper.

摘要

众所周知,前交叉韧带(ACL)重建需要结合详细的术后康复,以便患者恢复到受伤前的活动水平,并且康复过程与重建手术同样重要。文献研究聚焦于ACL术后康复期康复方式能够多早开始。尽管关于该主题的研究数量众多,但术后ACL康复方案尚未标准化。常见的、“固化”的知识或方式在文献中真的能得到验证吗?诸如“术后使用支具真的有必要吗?”“早期恢复活动范围(ROM)有哪些益处?”“神经肌肉电刺激(NMES)在预防肌肉萎缩方面的效果如何?”“本体感觉训练和开链运动能多早开始?”“强化训练应该在术后即刻开始吗?”等问题能够得到确切解答吗?我的目的是基于多项研究(证据等级1和2),对术后ACL康复这一非常全面主题中的常见方式,即术后支具使用、早期ROM恢复、NMES、本体感觉、开/闭链运动和早期强化进行综述,并呈现目前普遍认可的使用方式。此外,我在论文的表格中展示了术后ACL康复的目标,并在最后一章介绍了近期的其他研究。

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