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全膝关节置换术后早期使用单关节混合辅助肢体作为新治疗设备进行康复:一项随机、对照的临床初步研究。

Rehabilitation during early postoperative period following total knee arthroplasty using single-joint hybrid assistive limb as new therapy device: a randomized, controlled clinical pilot study.

机构信息

Department of General and Trauma Surgery, BG University Hospital Bergmannsheil Bochum, Ruhr University Bochum, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany.

Department of Spinal Cord Injuries, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany.

出版信息

Arch Orthop Trauma Surg. 2022 Dec;142(12):3941-3947. doi: 10.1007/s00402-021-04245-9. Epub 2021 Nov 16.


DOI:10.1007/s00402-021-04245-9
PMID:34783882
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9596552/
Abstract

INTRODUCTION: The first weeks after total knee arthroplasty (TKA) are crucial for the functional outcome. To improve knee mobility, a continuous passive motion (CPM) motor rail is commonly used during in-hospital rehabilitation. The single-joint hybrid assistive limb (HAL-SJ) is a new therapy device. The aim of the study was to improve patients' range of motion (ROM), mobility, and satisfaction using the active-assistive support of the HAL-SJ. MATERIALS AND METHODS: Between 09/2017 and 10/2020, 34 patients, who underwent TKA and matched the inclusion criteria, were randomized into study (HAL-SJ) and control (CPM) group. Treatment began after drain removal and was carried out until discharge. Primary outcome parameters were raised pre- and postoperatively and included the Oxford knee score (OKS), visual analog scale (VAS), and acquired range of motion. Furthermore complications caused by the device were recorded. RESULTS: OKS increased in both groups postoperatively, but only significantly in the HAL-SJ group. Postoperative pain improved in both groups without significant differences. Flexion improvement was significant in both groups between days 3/7 and 8 weeks postoperatively. We did not encounter any complications related to HAL-SJ. CONCLUSIONS: In conclusion, use of the HAL-SJ during rehabilitation in the early postoperative period after TKA was safe without disadvantages compared to the control group and seems to have advantages in terms of daily life impairment.

摘要

引言:全膝关节置换术(TKA)后最初的几周对功能结果至关重要。为了改善膝关节活动度,在住院康复期间通常使用连续被动运动(CPM)电机轨。单关节混合辅助肢体(HAL-SJ)是一种新的治疗设备。该研究的目的是通过 HAL-SJ 的主动辅助支持来改善患者的关节活动度(ROM)、活动能力和满意度。

材料和方法:在 2017 年 9 月至 2020 年 10 月期间,34 名接受 TKA 且符合纳入标准的患者被随机分为研究(HAL-SJ)和对照组(CPM)。治疗从引流管移除后开始,持续到出院。主要的结局参数是术前和术后的测量结果,包括牛津膝关节评分(OKS)、视觉模拟评分(VAS)和获得的关节活动度。此外,还记录了与设备相关的并发症。

结果:两组术后 OKS 均增加,但仅 HAL-SJ 组有显著增加。两组术后疼痛均有改善,无显著差异。两组术后 3/7 天至 8 周,膝关节屈曲度均有显著改善。我们没有遇到与 HAL-SJ 相关的任何并发症。

结论:总之,与对照组相比,在 TKA 后早期康复期间使用 HAL-SJ 是安全的,没有劣势,并且在日常生活障碍方面似乎有优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f66/9596552/8b60931a7c25/402_2021_4245_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f66/9596552/529c99d4d23c/402_2021_4245_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f66/9596552/cf5eb84b292c/402_2021_4245_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f66/9596552/8b60931a7c25/402_2021_4245_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f66/9596552/529c99d4d23c/402_2021_4245_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f66/9596552/cf5eb84b292c/402_2021_4245_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f66/9596552/8b60931a7c25/402_2021_4245_Fig3_HTML.jpg

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J Musculoskelet Neuronal Interact. 2025-6-1

[2]
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[4]
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[5]
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[6]
Single-facility study of the effectiveness of rehabilitation therapy using wearable hybrid assistive limb for patients with bleeding disorders: study protocol for a randomised controlled trial.

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本文引用的文献

[1]
A retrospective analysis of trends in primary knee arthroplasty in Germany from 2008 to 2018.

Sci Rep. 2021-3-4

[2]
Feasibility and efficacy of knee extension training using a single-joint hybrid assistive limb, versus conventional rehabilitation during the early postoperative period after total knee arthroplasty.

J Rural Med. 2021-1

[3]
Robotic rehabilitation of the paralyzed upper limb for a stroke patient using the single-joint hybrid assistive limb: a case study assessed by accelerometer on the wrist.

J Phys Ther Sci. 2020-2

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PLoS One. 2020-2-28

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The Effect Of Dexmedetomidine As Adjuvant To Ropivacaine 0.1% For Femoral Nerve Block On Strength Of Quadriceps Muscle In Patients Undergoing Total Knee Arthroplasty: A Double-Blinded Randomized Controlled Trial.

J Pain Res. 2019-12-17

[6]
Feasibility of supplemental robot-assisted knee flexion exercise following total knee arthroplasty.

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Cardiology. 2019

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Effects of Home-Based Robotic Therapy Involving the Single-Joint Hybrid Assistive Limb Robotic Suit in the Chronic Phase of Stroke: A Pilot Study.

Biomed Res Int. 2019-3-18

[9]
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Front Neurosci. 2019-3-29

[10]
Safety and efficacy of robotic elbow training using the upper limb single-joint hybrid assistive limb combined with conventional rehabilitation for bilateral obstetric brachial plexus injury with co-contraction: a case report.

J Phys Ther Sci. 2019-2

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