Ru T F, Li F F, Yuan L, Xie W G
Institute of Burns, Tongren Hospital of Wuhan University & Wuhan Third Hospital, Wuhan 430060, China.
Department of Rehabilitation, Hubei Provincial Organ Hospital, Wuhan 430071, China.
Zhonghua Shao Shang Za Zhi. 2019 Jun 20;35(6):428-433. doi: 10.3760/cma.j.issn.1009-2587.2019.06.006.
To observe the therapeutic effects of Archimedes sling system in the rehabilitation of knee joint flexion dysfunction of patients after deep burns. Thirty-seven patients with knee joint flexion dysfunction after deep burn, conforming to the study criteria and hospitalized in Burn Rehabilitation Center of Tongren Hospital of Wuhan University & Wuhan Third Hospital from March 2015 to December 2017, were recruited in this prospective controlled study. According to the order of admission, 18 odd-numbered patients and 19 even-numbered patients were enrolled in conventional treatment (CT) group [13 males and 5 females, aged (42±10) years] and sling treatment (ST) group [13 males and 6 females, aged (37±10) years] respectively. Patients in group CT were conventionally conducted with knee joint mobilization treatment, continuous passive motion treatment, and pressure therapy, while patients in group ST were conducted with supine knee joint flexion and extension training and micro-squat short arc resistance training with Archimedes sling system besides CT. Patients in the 2 groups were treated for 6 months, and 1 course of treatment was 1 month. Before treatment and after 6 months of treatment, the knee joint active motion range was measured and the difference value was calculated, the American Hospital for Special Surgery (HSS) knee joint score was used to assess the functional disorder of patients, and the self-function satisfaction of patients were evaluated with modified Likert Scale. Data were processed with independent sample test, paired sample test, and chi-square test. (1) Before treatment, the difference value of knee joint active motion range of patients in group CT was (45±11)°, which was similar to (44±12)° in group ST (=-0.206, >0.05). After 6 months of treatment, the difference value of knee joint active motion range of patients in group ST was (89±14)°, which was obviously higher than (75±12)° in group CT (=0.897, <0.01). The difference values of knee joint active motion range of patients in groups CT and ST after 6 months of treatment were obviously higher than those before treatment (=-13.394, -29.459, <0.01). (2) Before treatment, the HSS knee joint score of patients in group CT was (40±10) points, which was similar to (36±11) points in group ST (=0.816, >0.05). After 6 months of treatment, the HSS knee joint score of patients in group ST was (68±13) points, which was obviously higher than (57±10) points in group CT (=0.162, <0.01). The HSS knee joint score of patients in groups CT and ST after 6 months of treatment were obviously higher than those before treatment (=-12.410, -30.559, <0.01). (3) Before treatment, the self-function satisfaction scores of patients in the two groups were similar (=0.140, >0.05). After 6 months of treatment, the self-function satisfaction score of patients in group ST was obviously higher than that in group CT (=3.103, <0.01). The self-function satisfaction scores of patients in groups CT and ST after 6 months of treatment were obviously higher than those before treatment (=-11.697, -29.029, <0.01). The Archimedes sling system can effectively increase the difference value of knee joint active motion range, alleviate the degree of knee joint dysfunction, and enhance the self-function satisfaction of patients on the basis of conventional rehabilitation treatment for patients with knee joint flexion dysfunction after deep burns.
观察阿基米德悬吊系统对深度烧伤患者膝关节屈曲功能障碍康复的治疗效果。选取2015年3月至2017年12月在武汉大学同仁医院暨武汉市第三医院烧伤康复中心住院、符合研究标准的37例深度烧伤后膝关节屈曲功能障碍患者,进行这项前瞻性对照研究。按照入院顺序,将18例奇数患者和19例偶数患者分别纳入传统治疗(CT)组[男13例,女5例,年龄(42±10)岁]和悬吊治疗(ST)组[男13例,女6例,年龄(37±10)岁]。CT组患者常规进行膝关节松动治疗、持续被动运动治疗和压力治疗,而ST组患者除CT治疗外,还采用阿基米德悬吊系统进行仰卧位膝关节屈伸训练和微蹲短弧抗阻训练。两组患者均治疗6个月,1个疗程为1个月。治疗前及治疗6个月后,测量膝关节主动活动范围并计算差值,采用美国特种外科医院(HSS)膝关节评分评估患者功能障碍情况,用改良Likert量表评估患者自我功能满意度。数据采用独立样本t检验、配对样本t检验和卡方检验进行处理。(1)治疗前,CT组患者膝关节主动活动范围差值为(45±11)°,与ST组的(44±12)°相似(t=-0.206,P>0.05)。治疗6个月后,ST组患者膝关节主动活动范围差值为(89±14)°,明显高于CT组的(75±12)°(t=0.897,P<0.01)。CT组和ST组患者治疗6个月后的膝关节主动活动范围差值均明显高于治疗前(t=-13.394,-29.459,P<0.01)。(2)治疗前,CT组患者HSS膝关节评分为(40±10)分,与ST组的(36±11)分相似(t=0.816,P>0.05)。治疗6个月后,ST组患者HSS膝关节评分为(68±13)分,明显高于CT组的(57±10)分(t=0.162,P<0.01)。CT组和ST组患者治疗6个月后的HSS膝关节评分均明显高于治疗前(t=-12.410,-30.559,P<0.01)。(3)治疗前,两组患者自我功能满意度评分相似(t=0.140,P>0.05)。治疗6个月后ST组患者自我功能满意度评分明显高于CT组(t=3.103,P<0.01)。CT组和ST组患者治疗6个月后的自我功能满意度评分均明显高于治疗前(t=-11.697,-29.029,P<0.01)。阿基米德悬吊系统在深度烧伤后膝关节屈曲功能障碍患者的传统康复治疗基础上,能有效增加膝关节主动活动范围差值,减轻膝关节功能障碍程度,提高患者自我功能满意度。