Yaari Lee, Kosashvili Yona, Segal Ganit, Shemesh Shai, Velkes Steven, Mor Amit, Debi Ronen, Bernfeld Benjamin, Elbaz Avi
Department of Orthopedic Surgery, Rabin Medical Center, Petah Tikva, Israel.
AposTherapy Research Group, Herzliya, Israel.
Clin Orthop Surg. 2015 Jun;7(2):191-8. doi: 10.4055/cios.2015.7.2.191. Epub 2015 May 18.
Many factors contribute to suboptimal results after total knee arthroplasty (TKA) but little is known regarding the value of postsurgical rehabilitation after TKA. We examined the effects of an enhanced closed kinematic chain exercises program (AposTherapy) on gait patterns and clinical outcomes among patients with a lack of progress in their postsurgical rehabilitation.
Twenty-two patients were prospectively followed during the study. Gait spatiotemporal parameters were measured at the initial evaluation, after 15 minutes of therapy, and after 3 months of therapy. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the short form (SF) 36 health survey were completed by patients before treatment and after 3 months of treatment.
The WOMAC and SF-36 scores improved significantly after 3 months of treatment. Gait velocity, single limb support, and step length of the operated leg improved significantly even after a single 15 minutes treatment. Normal gait velocity was observed in 36% of patients after 3 months of treatment.
A physiotherapy program that included enhanced closed kinematic chain biomechanical therapy was beneficial for patients who experienced a suboptimal rehabilitation course after TKA.
全膝关节置换术（TKA）后效果欠佳由多种因素导致，但关于TKA术后康复的价值却知之甚少。我们研究了强化闭链运动训练计划（AposTherapy）对术后康复进展不佳患者步态模式和临床结局的影响。
在研究期间对22例患者进行前瞻性随访。在初始评估时、治疗15分钟后以及治疗3个月后测量步态时空参数。患者在治疗前和治疗3个月后完成西安大略和麦克马斯特大学骨关节炎指数（WOMAC）以及简短健康调查问卷（SF-36）。
治疗3个月后，WOMAC和SF-36评分显著改善。即使仅进行一次15分钟的治疗，患侧下肢的步态速度、单腿支撑时间和步长也有显著改善。治疗3个月后，36%的患者观察到正常步态速度。
对于TKA术后康复过程不理想的患者，包含强化闭链生物力学治疗的物理治疗计划有益。
