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糖尿病对全膝关节置换术后功能、力量和自我报告测量恢复轨迹的影响。

Influence of Diabetes Mellitus on the Recovery Trajectories of Function, Strength, and Self-Report Measures After Total Knee Arthroplasty.

机构信息

University of Colorado, Aurora.

University of Utah, Salt Lake City.

出版信息

Arthritis Care Res (Hoboken). 2019 Aug;71(8):1059-1067. doi: 10.1002/acr.23741. Epub 2019 Jul 8.

Abstract

OBJECTIVE

As the proportion of individuals with diabetes mellitus (DM) in the aging population and the number of total knee arthroplasties (TKAs) both continue to grow, understanding the outcomes for these patient populations is critical. The purpose of this study was to determine whether patients with and without DM differed in the recovery of 3 physical performance measures during the first 90 days following a TKA.

METHODS

Data collected at ATI Physical Therapy from 169 patients (37 with DM, and 132 without) were available. Physical performance measures included the 4-meter walk test, the 30-second sit-to-stand test (30STS), and the timed-up-and-go test (TUG). A mixed-effects model was performed to determine differences in the rate of recovery and 90-day postoperative scores for all measures.

RESULTS

Both groups had similar baseline values for all measures. Patients with DM demonstrated a slower rate of recovery for the 4-meter walk test, and worse scores for the 4-meter walk test, 30STS, and TUG at the end of 90 days when accounting for significant covariates.

CONCLUSION

Our findings show a negative relationship between the presence of DM and the recovery trajectories of all physical performance measures. Clinicians should closely monitor patients with DM, knowing that they are at higher risk for sustained functional deficits and early complications.

摘要

目的

随着糖尿病(DM)患者在老年人群中的比例以及全膝关节置换术(TKA)数量的不断增加,了解这些患者群体的结局至关重要。本研究旨在确定 TKA 后 90 天内,患有和不患有 DM 的患者在 3 项身体机能测量指标的恢复情况上是否存在差异。

方法

ATI 物理治疗中心收集了 169 名患者(37 名患有 DM,132 名未患有 DM)的数据。身体机能测量指标包括 4 米步行测试、30 秒坐站测试(30STS)和计时起立行走测试(TUG)。采用混合效应模型来确定所有测量指标的恢复率和 90 天术后评分的差异。

结果

两组患者在所有测量指标上的基线值均相似。患有 DM 的患者在 4 米步行测试中的恢复速度较慢,在考虑到重要协变量后,在 90 天结束时,其 4 米步行测试、30STS 和 TUG 的评分更差。

结论

我们的研究结果表明,DM 的存在与所有身体机能测量指标的恢复轨迹之间存在负相关关系。临床医生应密切监测患有 DM 的患者,因为他们有持续存在功能缺陷和早期并发症的较高风险。

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