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前交叉韧带重建术后由移动应用程序引导的自我康复可改善早期活动并减轻疼痛。

Self-Rehabilitation Guided by a Mobile Application After Anterior Cruciate Ligament Reconstruction Leads to Improved Early Motion and Less Pain.

作者信息

Foissey Constant, Thaunat Mathieu, Bondoux Louka, Sonnery-Cottet Bertrand, Fayard Jean-Marie

机构信息

Centre Orthopédique Santy, Lyon, France.

Hôpital Privé Jean Mermoz, Ramsay-Générale de Santé, Lyon, France.

出版信息

Arthrosc Sports Med Rehabil. 2021 Aug 8;3(5):e1457-e1464. doi: 10.1016/j.asmr.2021.07.007. eCollection 2021 Oct.

Abstract

PURPOSE

To evaluate the adherence rate and the contribution of self-rehabilitation (SR) guided by a mobile application after anterior cruciate ligament reconstruction (ACLR) in combination with physical therapy sessions on early knee function.

METHODS

This study was a retrospective analysis of prospectively collected data from a single health care facility. All patients who underwent ACLR by a single surgeon from December 2019 to September 2020 were included. Two groups were formed and compared based on use of the mobile app: users (>10 days of use) and nonusers (≤10 days of use). Outcomes included physical examination at 3 and 6 weeks postoperatively.

RESULTS

A total of 65 patients were analyzed: 19 in the nonuser group and 46 in the user group. Adherence rate was 91% at 10 days, 71% at 15 days, 62% at 21 days, and 44% at 45 days. At 3 weeks, the user group was 3.86 times [range 1.12 to 13.3] as likely to lock the quadriceps during gait with crutches and was 4.2 times [range 1.2 to 14.3] as likely to be pain free. There was a tendency to have less flexion contracture in the user group (17% versus 32%,  = .32). At 6 weeks, the differences leveled out, but the user group still had slightly better quadriceps locking during gait without crutches (87% versus 79%,  = .46).

CONCLUSIONS

SR guided by a mobile app combined with a standard rehabilitation protocol is correlated with better knee function at initial follow-up.

LEVEL OF EVIDENCE

IV, therapeutic case series.

摘要

目的

评估在接受前交叉韧带重建术(ACLR)后,由移动应用程序引导的自我康复(SR)与物理治疗相结合对早期膝关节功能的依从率及贡献。

方法

本研究是对来自单一医疗机构的前瞻性收集数据进行的回顾性分析。纳入了2019年12月至2020年9月由同一位外科医生进行ACLR的所有患者。根据移动应用程序的使用情况将患者分为两组并进行比较:使用者(使用超过10天)和非使用者(使用≤10天)。观察指标包括术后3周和6周的体格检查。

结果

共分析了65例患者:非使用者组19例,使用者组46例。10天时依从率为91%,15天时为71%,21天时为62%,45天时为44%。在3周时,使用者组在使用拐杖行走时股四头肌锁定的可能性是对照组的3.86倍(范围为1.12至13.3),且无痛的可能性是对照组的4.2倍(范围为1.2至14.3)。使用者组有屈曲挛缩较少的趋势(17%对32%,P = 0.32)。在6周时,差异趋于平稳,但使用者组在不使用拐杖行走时股四头肌锁定情况仍略好(87%对79%,P = 0.46)。

结论

由移动应用程序引导的自我康复与标准康复方案相结合,在初始随访时与更好的膝关节功能相关。

证据水平

IV级,治疗性病例系列。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3780/8527319/6a432c233332/gr1.jpg

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