Lekmed Medical Center, Warsaw Medical University, Warszawa, Poland.
Department of Clinical Rehabilitation, Warsaw Medical University, Warsaw, Poland.
Adv Exp Med Biol. 2018;1096:1-9. doi: 10.1007/5584_2018_187.
The aim of the study was to assess the influence of a physiotherapy program based on proprioceptive neuromuscular facilitation (PNF) on kinematic gait pattern after total knee arthroplasty. This comparative study included two groups of patients qualified for total surgical knee joint replacement due to osteoarthritis: a study group and a control group, either consisting of 28 patients of a matched age range of 55-90 years. Following surgery, 4 days after standard postoperative rehabilitation, the study patients were subjected to a 3-week-long therapist-assisted rehabilitation based on PNF principles (10 sessions of 75 min each), whereas control patients were discharged with instructions on how to exercise in the home setting. The outcome consisted of spatial-temporal gait parameters that were assessed at three time points: a day before surgery and then 1 month and 6 months after. The findings were that PNF caused substantial, sustained improvements in gait kinematics, shortening the stance phases, gait cycle duration, and double support phase and prolonging swing phase velocity, gait velocity, cadence, step length, and gait cycle length. Also, postsurgical pain was evidently less. We conclude that the individually tailored PNF rehabilitation program is superior compared to a standard recommendation of home-based physiotherapy in terms of improving gait kinematic pattern as well as psychological aspects related to pain perception in patients after knee arthroplasty.
本研究旨在评估基于本体感觉神经肌肉促进（PNF）的物理治疗方案对全膝关节置换术后步态运动学模式的影响。这是一项对比研究，纳入了两组因骨关节炎而符合全膝关节置换手术条件的患者：研究组和对照组，每组均有 28 名年龄在 55-90 岁之间的匹配患者。手术后，在标准术后康复 4 天后，研究组患者接受了为期 3 周的基于 PNF 原则的治疗师辅助康复治疗（10 次，每次 75 分钟），而对照组患者则在出院时获得了在家中锻炼的指导。结果包括时空步态参数，这些参数在三个时间点进行评估：手术前一天，以及术后 1 个月和 6 个月。结果表明，PNF 可显著、持续地改善步态运动学，缩短站立相、步态周期持续时间和双支撑相，延长摆动相速度、步态速度、步频、步长和步态周期长度。此外，术后疼痛明显减轻。我们得出结论，与标准的家庭物理治疗建议相比，个体化的 PNF 康复方案在改善膝关节置换术后患者的步态运动模式以及与疼痛感知相关的心理方面更具优势。
