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动作观察疗法对全膝关节置换术后恢复的影响:一项前瞻性临床试验。

Effects of action observation treatment in recovery after total knee replacement: a prospective clinical trial.

作者信息

Villafañe Jorge Hugo, Isgrò Maria, Borsatti Maria, Berjano Pedro, Pirali Caterina, Negrini Stefano

机构信息

1 IRCCS Don Gnocchi Foundation, Milan, Italy.

2 IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.

出版信息

Clin Rehabil. 2017 Mar;31(3):361-368. doi: 10.1177/0269215516642605. Epub 2016 Jul 10.

Abstract

OBJECTIVE

We hypothesized that self-administered action observation treatment can increase the effectiveness of inpatient rehabilitation of patients after a primary total knee replacement.

DESIGN

A pilot randomized controlled trial.

SETTING

Thirty-one inpatients, admitted to our Physical and Rehabilitation Medicine Department.

SUBJECTS

After a primary total knee replacement were randomly assigned to either an experimental ( n=14) or control ( n=17) group.

INTERVENTION

All subjects received conventional physiotherapy and were required to perform additional self-administered exercises explained in a written informative brochure. Subjects in the experimental group were asked to watch a video showing a person exercising whilst the control group watched a nature video without exercises being shown.

MAIN OUTCOMES MEASURE

Changes in Visual Analogue Scale, active and passive range of motion of knee, Barthel index, Short Form-36 Health Survey, Tinetti scale, Lequesne index measurements.

RESULTS

At the end of the intervention period, the increase of the active range of motion over the active flexion and extension in the experimental group was higher than in the control group; the difference between groups was 15.6° (95%CI 5.3-24.8) and 3.4° (95%CI 1.1-5.6), for active flexion and active extension respectively; between-group effect sizes were large at post-treatment period (d>1.3).

CONCLUSIONS

adding action observation training to conventional inpatient physiotherapy is associated with a greater degree of recovery in patients who have undergone a primary total knee replacement.

摘要

目的

我们假设自我管理的动作观察疗法可以提高初次全膝关节置换术后患者住院康复的效果。

设计

一项试点随机对照试验。

地点

31名住院患者,入住我们的物理医学与康复科。

受试者

初次全膝关节置换术后的患者被随机分为实验组(n = 14)或对照组(n = 17)。

干预措施

所有受试者均接受常规物理治疗,并被要求按照一份书面信息手册中解释的内容进行额外的自我管理练习。实验组的受试者被要求观看一段展示某人锻炼的视频,而对照组观看一段未展示锻炼内容的自然视频。

主要结局指标

视觉模拟评分、膝关节主动和被动活动范围、Barthel指数、简明健康调查量表、Tinetti量表、Lequesne指数测量值的变化。

结果

在干预期结束时,实验组主动活动范围在主动屈伸方面的增加高于对照组;主动屈伸时组间差异分别为15.6°(95%CI 5.3 - 24.8)和3.4°(95%CI 1.1 - 5.6);治疗后期组间效应量较大(d>1.3)。

结论

在常规住院物理治疗中加入动作观察训练与初次全膝关节置换术后患者更大程度的恢复相关。

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