Carlisi Ettore, Caspani Patrick, Morlino Paola, Bardoni Maria Teresa, Lisi Claudio, Bejor Maurizio, Dalla Toffola Elena
Physical Medicine and Rehabilitation Unit, I.R.C.C.S. Policlinico San Matteo Foundation & University of Pavia, Pavia.
Acta Biomed. 2017 Aug 23;88(2):167-171. doi: 10.23750/abm.v88i2.5035.
Functional activity may remain limited in patients affected by critical limb ischemia, despite successful infrainguinal lower limb bypass surgery (ILLBS). The aim of the work was to evaluate the impact of a rehabilitative intervention on postoperative ambulatory status and pain.
In an observational study, data were collected on 34 patients undergoing ILLBS for critical limb ischemia or end-stage peripheral arterial disease. All patients underwent a postoperative rehabilitation program aimed at recovering gait autonomy. Information was collected on pre-operative comorbidities, ambulatory status (on admission to and discharge from hospital) and pain in the affected lower limb (on the first physiotherapy session and at discharge).
Before ILLBS, 61.8% of the patients walked independently without aids or assistance. The rehabilitative program started on average 5.7 (SD: 2.1) days after surgery. At discharge, 50% of the patients walked independently, 41.2% walked with aids and/or assistance and 8.8% were not able to walk. Overall, 76.5% of the sample recovered their pre-operative ambulatory status. Although pain tended to decrease, the difference at the first (1.5; SD: 2.6) and at the last treatment session (0.8; SD= 1.3) was not statistically significant.
Our exercise protocol resulted to be easy to perform during hospital stay, with an overall favourable outcome for ambulatory status. Our results are in line with those reported in literature about the rates of postoperative dependence in walking, but appear to be slightly better in regards to the percentage of patients who recovered pre-operative ambulatory status.
尽管下肢腹股沟下旁路手术（ILLBS）成功，但严重肢体缺血患者的功能活动可能仍受限。本研究旨在评估康复干预对术后步行状态和疼痛的影响。
在一项观察性研究中，收集了34例因严重肢体缺血或终末期外周动脉疾病接受ILLBS手术患者的数据。所有患者均接受旨在恢复步态自主性的术后康复计划。收集术前合并症、步行状态（入院时和出院时）以及患侧下肢疼痛（首次物理治疗时和出院时）的信息。
ILLBS手术前，61.8%的患者无需辅助或帮助即可独立行走。康复计划平均在术后5.7（标准差：2.1）天开始。出院时，50%的患者能够独立行走，41.2%的患者需借助辅助工具和/或他人帮助行走，8.8%的患者无法行走。总体而言，76.5%的样本恢复到术前的步行状态。尽管疼痛有减轻趋势，但首次治疗时（1.5；标准差：2.6）和最后一次治疗时（0.8；标准差 = 1.3）的差异无统计学意义。
我们的运动方案在住院期间易于实施，对步行状态总体效果良好。我们的结果与文献报道的术后步行依赖率一致，但在恢复术前步行状态的患者百分比方面似乎略好。
