Yoshioka Tomokazu, Kubota Shigeki, Sugaya Hisashi, Arai Norihito, Hyodo Kojiro, Kanamori Akihiro, Yamazaki Masashi
Division of Regenerative Medicine for Musculoskeletal System, Faculty of Medicine, University of Tsukuba, Japan.
Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Japan.
J Rural Med. 2021 Jan;16(1):22-28. doi: 10.2185/jrm.2020-024. Epub 2021 Jan 5.
To evaluate the feasibility and efficacy of treatment for the recovery of knee joint function after total knee arthroplasty (TKA) using a robotic suit. Knee joint extension exercise sessions were started with a robotic suit (single-joint hybrid assistive limb [HAL-SJ, Cyberdyne, Inc., Tsukuba, Japan]) in one group of patients after TKA. Patients who underwent standard rehabilitation were enrolled in the control group. To evaluate feasibility and safety, we assessed the adverse events, the number of training sessions, and training time. We compared the changes in knee joint pain and extension lag (°) between the groups. The average age was 71.3 ± 6.2 years in the HAL-SJ group and 74.9 ± 8.7 years in the control group. There were no severe adverse events. In the HAL-SJ group, training was performed 2.9 times, on average, and lasted 18.8 min. In the HAL-SJ group, there was a reduction in the visual analog scale (VAS) for pain after training, which was not significant. In the control group, the VAS score worsened after the sessions. The extension lag significantly improved in the HAL-SJ group after the 2nd and 3rd sessions, and this was more due to improvements in their active extension range of motion than their passive extension range of motion. HAL-SJ-based training is safe and effective, and leads to instantaneous improvement of extension lag, without worsening knee joint pain. HAL-SJ-based knee extension training could represent a viable novel post-TKA rehabilitation modality.
评估使用机器人套装治疗全膝关节置换术(TKA)后膝关节功能恢复的可行性和疗效。一组TKA术后患者使用机器人套装(单关节混合辅助肢体[HAL-SJ,日本筑波赛博动力公司])开始进行膝关节伸展锻炼。接受标准康复治疗的患者纳入对照组。为了评估可行性和安全性,我们评估了不良事件、训练次数和训练时间。我们比较了两组之间膝关节疼痛和伸展滞后(°)的变化。HAL-SJ组的平均年龄为71.3±6.2岁,对照组为74.9±8.7岁。未发生严重不良事件。在HAL-SJ组,平均训练2.9次,持续18.8分钟。在HAL-SJ组,训练后疼痛的视觉模拟量表(VAS)有所降低,但不显著。在对照组,训练后VAS评分恶化。在HAL-SJ组,第2次和第3次训练后伸展滞后明显改善,这更多是由于主动伸展活动范围的改善而非被动伸展活动范围的改善。基于HAL-SJ的训练是安全有效的,可导致伸展滞后立即改善,且不会加重膝关节疼痛。基于HAL-SJ的膝关节伸展训练可能是一种可行的新型TKA术后康复方式。
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