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基于两种不同方案的全膝关节置换术后运动功能和自我效能恢复的比较:一项前瞻性队列研究。

Comparison of recovery of mobility and self-efficacy after total knee arthroplasty based on two different protocols: A prospective cohort study.

机构信息

Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Department of Physical Therapy, School of Health Sciences, Tokyo University of Technology, Tokyo, Japan.

出版信息

Mod Rheumatol. 2020 Jan;30(1):197-203. doi: 10.1080/14397595.2018.1553228. Epub 2019 Jan 3.

Abstract

: The purpose of this study was to compare the recovery of mobility and self-efficacy following total knee arthroplasty (TKA) between the 5-day and the 28-day protocol. This prospective cohort study was carried out at two hospitals.: In total, 104 patients who underwent TKA were enrolled. The primary outcomes measured were Life Space Assessment (LSA) for mobility and modified-Gait Efficacy Scale (mGES) for self-efficacy. Knee Society Score (KSS) was used to estimate the functional outcomes. These assessments were performed in all patients preoperatively, and at 1, 3, and 6 months postoperatively. After calculating the propensity score using covariates, such as patient characteristics, LSA, mGES, and KSS at baseline, propensity score-adjusted multivariate analysis of covariance (MANCOVA) was performed.: MANCOVA revealed significant differences in LSA and mGES, but not in KSS, between the two protocols. The adjusted means of LSA and mGES in the 28-day protocol were significantly greater than those in the 5-day protocol in all the postoperative assessments.: Mobility and self-efficacy were greater following the 28-day protocol than the 5-day protocol after TKA. Our findings suggest that the modified treatment procedure for improving mobility and self-efficacy is necessary to introduce the early discharge protocol in Japan.

摘要

: 本研究旨在比较全膝关节置换术(TKA)后 5 天和 28 天方案在移动能力和自我效能恢复方面的差异。这是一项前瞻性队列研究,在两家医院进行。

: 共纳入 104 例接受 TKA 的患者。主要结局指标为移动能力的生活空间评估(LSA)和自我效能的改良步态功效量表(mGES)。膝关节学会评分(KSS)用于评估功能结局。所有患者在术前以及术后 1、3 和 6 个月进行这些评估。在使用协变量(如患者特征、基线时的 LSA、mGES 和 KSS)计算倾向评分后,进行了倾向评分调整的多元协方差分析(MANCOVA)。

: MANCOVA 显示,两种方案在 LSA 和 mGES 方面存在显著差异,但在 KSS 方面没有差异。在所有术后评估中,28 天方案的 LSA 和 mGES 的调整平均值均显著大于 5 天方案。

: TKA 后,28 天方案的移动能力和自我效能均高于 5 天方案。我们的研究结果表明,需要引入一种改良的治疗方案,以提高移动能力和自我效能,从而在日本引入早期出院方案。

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