Bakırhan Serkan, Ünver Bayram, Karatosun Vasfi
İzmir University School of Health, Department of Physiotherapy and Rehabilitation, İzmir, Turkey.
Dokuz Eylül University School of Physical Therapy and Rehabilitation, İzmir, Turkey.
Acta Orthop Traumatol Turc. 2015;49(5):497-502. doi: 10.3944/AOTT.2015.15.0015.
The aim of this study was to compare the effects of two different continuous passive motion (CPM) application protocols (low- and high-angle) on the early phase functional activities of total knee arthroplasty inpatients.
The study included 170 patients who underwent primary TKA. While 84 of the TKA patients underwent low-angle CPM application, 86 of the patients underwent high-angle CPM application. The patients' functional activities were compared using the Iowa Level of Assistance Scale (ILAS), gait speeds using the Iowa Ambulation Velocity Scale (IAVS), knee scores using the Hospital for Special Surgery (HSS) Knee Score, and the duration of hospital stays with the Visual Analog Scale (VAS) preoperatively and on postoperative Day 2, Day 6, and at discharge.
It was found that patients in the high-angle group had lower pain levels than did the patients in the low-angle group postsurgery (p<0.05). Patients in the high-angle group achieved their functional activities more independently on postoperative Day 2, Day 6, and at discharge than did the patients in the low-angle group (p<0.05). However, gait speed of patients in the former group was lower than that of the patients in the latter group (p<0.05).
Although low-angle CPM application produced better results in terms of gait speed following TKA, the high-angle CPM application was superior in terms of independence levels of functional activities in the early postsurgery period. This result suggests that the appropriate use of rehabilitation methods such as CPM applications may guide clinicians to increase patients' level of independence.
本研究旨在比较两种不同的持续被动运动(CPM)应用方案(低角度和高角度)对全膝关节置换术患者早期功能活动的影响。
该研究纳入了170例行初次全膝关节置换术(TKA)的患者。其中84例TKA患者接受低角度CPM应用,86例患者接受高角度CPM应用。使用爱荷华辅助水平量表(ILAS)比较患者的功能活动,使用爱荷华步行速度量表(IAVS)比较步态速度,使用特种外科医院(HSS)膝关节评分比较膝关节评分,并在术前、术后第2天、第6天和出院时使用视觉模拟量表(VAS)比较住院时间。
发现高角度组患者术后疼痛程度低于低角度组患者(p<0.05)。高角度组患者在术后第2天、第6天和出院时比低角度组患者在功能活动上更能独立完成(p<0.05)。然而,前一组患者的步态速度低于后一组患者(p<0.05)。
虽然低角度CPM应用在TKA后的步态速度方面产生了更好的结果,但高角度CPM应用在术后早期功能活动的独立水平方面更具优势。这一结果表明,适当使用CPM应用等康复方法可能会指导临床医生提高患者的独立水平。