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接受全膝关节置换术患者的术前功能参数

Pre-operative Functional Parameters of Patients Undergoing Total Knee Arthroplasty.

作者信息

Tambascia Rafael Andrade, Vasconcelos Rodrigo Antunes, Mello Wilson, Teixeira Paulo Portes, Grossi Debora Bevilaqua

机构信息

Program Performance and Functional Rehabilitation, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.

Center for Studies and Research, Instituto Wilson Mello, Campinas, São Paulo, Brazil.

出版信息

Physiother Res Int. 2016 Jun;21(2):77-83. doi: 10.1002/pri.1622. Epub 2015 Feb 27.

Abstract

BACKGROUND AND PURPOSE

Total knee arthroplasty (TKA) has become the gold standard to manage pain and disability associated with knee osteoarthritis (KOA). There are no clear criteria on to determine when or who should undergo TKA. The creation of a pre-operative profile that includes physical functional data may aid in the clinical decision-making for the timing of TKA. Aim 1: to observe the pre-operative functional profile of subjects with advanced KOA and to depict it according to gender. Aim 2: to assess the association between pain, self-reported and performance-based physical function outcomes.

STUDY DESIGN

retrospective study. Physical functional data from 122 persons (89 women and 33 men) with end-stage KOA were obtained through a database. Data consisted of height, weight, 6-minute walk test (6MWT) and the deficit when compared with normative values, self-visual analogue scale (VAS) after 6MWT and Western Ontario and McMaster Universities Index (WOMAC). Descriptive statistics were used to report the observed data; student t-test and Mann-Whitney were used to compare gender groups. Spearman correlation was used to asses the association with the 6MWT, WOMAC and VAS.

RESULTS

The mean (standard deviation) values of our sample for the WOMAC, 6MWT deficit and VAS were calculated. There was a significant difference between gender in the WOMAC score and pain intensity (VAS) after the 6MWT (p = 0.002; p = 0.01). Moderate to weak correlations between WOMAC score, VAS and 6MWT were found. Correlation values ranged from r = 0.23 to 0.48.

CONCLUSION

The current study suggests a functional profile for subjects who are scheduled to undergo TKA. Our results show that the correlations of self-report and performance-based measures of function and reported pain are poor. This enhances the idea of using all of these types of measures to establish the functional profile a sample of subjects with advanced KOA. Copyright © 2015 John Wiley & Sons, Ltd.

摘要

背景与目的

全膝关节置换术(TKA)已成为治疗与膝关节骨关节炎(KOA)相关疼痛和功能障碍的金标准。目前尚无明确标准来确定何时或哪些人应接受TKA。创建包含身体功能数据的术前概况可能有助于TKA手术时机的临床决策。目的1:观察晚期KOA患者的术前功能概况,并按性别进行描述。目的2:评估疼痛、自我报告的和基于表现的身体功能结果之间的关联。

研究设计

回顾性研究。通过数据库获取了122例(89名女性和33名男性)终末期KOA患者的身体功能数据。数据包括身高、体重、6分钟步行试验(6MWT)以及与标准值相比的差值、6MWT后的自我视觉模拟量表(VAS)和西安大略和麦克马斯特大学骨关节炎指数(WOMAC)。采用描述性统计报告观察到的数据;使用学生t检验和曼-惠特尼检验比较性别组。采用斯皮尔曼相关性分析评估与6MWT、WOMAC和VAS之间 的关联。

结果

计算了我们样本中WOMAC、6MWT差值和VAS的平均值(标准差)。6MWT后WOMAC评分和疼痛强度(VAS)在性别之间存在显著差异(p = 0.002;p = 0.01)。发现WOMAC评分、VAS和6MWT之间存在中度至弱相关性。相关值范围为r = 0.23至0.48。

结论

本研究提出了计划接受TKA患者的功能概况。我们的结果表明,自我报告的和基于表现的功能测量与报告的疼痛之间的相关性较差。这强化了使用所有这些类型的测量来建立晚期KOA患者样本功能概况的想法。版权所有© 2015约翰·威利父子有限公司。

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