Lu Jun, Liang Xiaojun, Ma Qiang
Surgeon, Foot and Ankle Surgery, Xi'an Honghui Hospital Affiliated to Xi'an Jiaotong University, Xi'an, China.
Professor, Foot and Ankle Surgery, Xi'an Honghui Hospital Affiliated to Xi'an Jiaotong University, Xi'an, China.
J Foot Ankle Surg. 2019 Sep;58(5):938-945. doi: 10.1053/j.jfas.2018.12.014.
The aim of this study was to investigate the role of early functional rehabilitation in acute Achilles tendon ruptures. Eligible studies were identified from PubMed, Embase, and the Cochrane Library using the following search keywords: "Achilles tendon rupture" and "rehabilitation" or "function" or "functional" or "mobilization" and "randomized" or "random" or "blind" or "control" or "compare" or "comparative." A heterogeneity test based on I statistic and Cochran's Q test was conducted. The pooled risk ratio and weighted mean difference with 95% confidence interval was calculated for each outcome using the random-effect (p < .05 or I > 50% for significant heterogeneity) or fixed-effect (p > .05 or I < 50% for nonsignificant heterogeneity) model. A subgroup analysis was also performed. Fourteen randomized controlled trials were identified. Pooled data demonstrated no difference in the complication rates, time taken to return to sports, total number of patients returning to work or sports, and satisfaction rate between the early functional rehabilitation and conventional cast immobilization groups. Early functional rehabilitation significantly decreased the time taken to return to work (weighted mean difference -1.56; 95% confidence interval -3.09 to 0.04; p = .04]. Early functional rehabilitation for acute Achilles tendon ruptures appeared to be related to a shorter time taken to return to work; however, it did not affect the other variables between the groups.
本研究旨在探讨早期功能康复在急性跟腱断裂中的作用。使用以下检索关键词从PubMed、Embase和Cochrane图书馆中检索符合条件的研究：“跟腱断裂”和“康复”或“功能”或“功能性”或“活动”以及“随机”或“随机化”或“盲法”或“对照”或“比较”或“对比”。基于I统计量和Cochrane Q检验进行异质性检验。使用随机效应模型（异质性显著时p <.05或I > 50%）或固定效应模型（异质性不显著时p >.05或I < 50%）计算每个结局的合并风险比和95%置信区间的加权平均差。还进行了亚组分析。共纳入14项随机对照试验。汇总数据显示，早期功能康复组与传统石膏固定组在并发症发生率、恢复运动所需时间、恢复工作或运动的患者总数以及满意度方面无差异。早期功能康复显著缩短了恢复工作所需时间（加权平均差 -1.56；95%置信区间 -3.09至0.04；p = 0.04）。急性跟腱断裂的早期功能康复似乎与缩短恢复工作所需时间有关；然而，它并未影响两组之间的其他变量。
