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同伴志愿者为全膝关节置换术后患者提供住院康复锻炼的短期效果。

Short-Term Effect of Peer Volunteers in Providing Inpatient Rehabilitative Exercises for Patients After Total Knee Arthroplasty.

机构信息

Department of Physiotherapy, Tan Tock Seng Hospital.

Department of Rehabilitation Medicine, Tan Tock Seng Hospital Rehabilitation Centre.

出版信息

Arch Phys Med Rehabil. 2021 Jul;102(7):1361-1367. doi: 10.1016/j.apmr.2021.03.004. Epub 2021 Mar 26.

Abstract

OBJECTIVE

To investigate the short-term outcomes at discharge of patients who receive additional postoperative rehabilitative exercises by peer volunteers after total knee arthroplasty (TKA).

DESIGN

Retrospective cohort study.

SETTING

Tertiary teaching hospital.

PARTICIPANTS

A total of 476 adult patients who had undergone a primary elective unilateral TKA (N=467).

INTERVENTIONS

An intervention group received a standardized postoperative rehabilitative exercise protocol taught and supervised by peer volunteers in additional to standard physiotherapy (n=309) compared with a control group receiving standard physiotherapy alone (n=167).

MAIN OUTCOME MEASURES

Discharge outcomes were the pain score using the Numeric Rating Scale pain score, passive knee flexion and extension range of motion (ROM), length of hospitalization, ability to perform an unassisted straight leg raise of the operated leg, ambulation distance, ability in independent walking, walking aids required, discharge destination, and adverse events.

RESULTS

On multivariate analysis, patients in the intervention group had an increased discharge passive knee flexion ROM of 7.89 degrees (95% confidence interval, 5.47-10.33; P<.001). There were no significant differences for the other outcome measures between the intervention and control group.

CONCLUSIONS

A rehabilitative exercise program by peer volunteers is feasible and safe after TKA in addition to standard physiotherapy and is associated with improved knee flexion ROM on discharge.

摘要

目的

研究接受同伴志愿者术后额外康复锻炼的全膝关节置换术(TKA)患者出院时的短期疗效。

设计

回顾性队列研究。

地点

三级教学医院。

参与者

共纳入 476 例接受初次单侧 TKA 的成年患者(N=467)。

干预

干预组在标准物理治疗的基础上,接受同伴志愿者教授和监督的标准化术后康复锻炼方案(n=309),而对照组仅接受标准物理治疗(n=167)。

主要观察指标

出院疗效指标为数字评分法(NRS)疼痛评分、被动膝关节屈伸活动度(ROM)、住院时间、能否完成患侧直腿抬高、步行距离、独立行走能力、所需助行器、出院去向和不良事件。

结果

多因素分析显示,干预组患者出院时被动膝关节屈曲 ROM 增加 7.89 度(95%置信区间,5.47-10.33;P<.001)。干预组与对照组在其他疗效指标方面无显著差异。

结论

在 TKA 后,除了标准物理治疗外,同伴志愿者的康复锻炼方案是可行且安全的,并与出院时膝关节屈曲 ROM 的改善相关。

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