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BFR 训练可改善 Colles 骨折固定后患者报告的结局、力量和活动范围。

BFR Training Improves Patients' Reported Outcomes, Strength, and Range of Motion After Casting for Colles' Fracture.

机构信息

School of Elite Sport, Shanghai University of Sport, Shanghai, CHINA.

Department of Orthopaedics, Nanjing First Hospital, Nanjing, CHINA.

出版信息

Med Sci Sports Exerc. 2023 Nov 1;55(11):1985-1994. doi: 10.1249/MSS.0000000000003228. Epub 2023 Jun 1.

Abstract

PURPOSE

This study compared traditional rehabilitation as a treatment modality after plaster cast treatment of Colles' fracture with a combination of individualized blood flow restriction (BFR) and traditional rehabilitation.

METHODS

Twenty-eight participants were randomized into a BFR group and a non-BFR group after plaster cast treatment of Colles' fracture. The BFR group completed traditional rehabilitation with a medical grade tourniquet applied to the upper arm, and the non-BFR group underwent traditional rehabilitation only. Patients were followed up with radiographic outcomes (palmar tilt and radial inclination) to ensure the stability of the fracture. Clinical assessment of patient-rated wrist evaluation (PRWE) score, grip strength, pinch strength, wrist range of motion (ROM), and muscle stiffness was conducted at cast removal and 6 wk after cast removal. Two-way repeated-measures ANOVA determined significant interactions between time and group in the aforementioned variables. An independent-sample t -test assessed the differences in baseline variables and radiographic outcomes.

RESULTS

Significant interactions between time and group were noted for PRWE score ( F = 11.796, P = 0.002, η2p = 0.339), grip strength ( F = 5.445, P = 0.029, η2p = 0.191), and wrist ROM (ulnar deviation; F = 7.856, P = 0.010, η2p = 0.255). No significant interactions between time and group were found in measurements of pinch strength or wrist ROM (flexion, extension, radial deviation, pronation, supination). An independent-sample t -test showed no significant difference in baseline variables and radiographic outcomes between the groups before or after intervention.

CONCLUSIONS

This study found that combining individualized BFR with traditional rehabilitation resulted in greater increases in PRWE score, grip strength, and wrist ROM (ulnar deviation) than traditional rehabilitation alone. Therefore, adding individualized BFR to traditional rehabilitation might be a better option for treatment for similar patients.

摘要

目的

本研究比较了石膏固定治疗科雷氏骨折后的传统康复治疗与个体化血流限制(BFR)联合传统康复治疗的效果。

方法

28 名患者在石膏固定治疗科雷氏骨折后随机分为 BFR 组和非 BFR 组。BFR 组在上臂应用医用止血带进行传统康复治疗,而非 BFR 组仅进行传统康复治疗。通过 X 线评估掌倾角和桡骨倾斜角来随访患者以确保骨折的稳定性。在去除石膏和去除石膏后 6 周时,对患者进行临床评估(腕关节患者自评评分(PRWE)、握力、捏力、腕关节活动度(ROM)和肌肉僵硬度)。采用双因素重复测量方差分析比较时间和组间上述变量的显著交互作用。采用独立样本 t 检验评估基线变量和 X 线结果的差异。

结果

PRWE 评分( F = 11.796, P = 0.002, η2p = 0.339)、握力( F = 5.445, P = 0.029, η2p = 0.191)和腕关节 ROM(尺偏; F = 7.856, P = 0.010, η2p = 0.255)时间与组之间存在显著交互作用。在捏力或腕关节 ROM(屈伸、桡偏、旋前、旋后)的测量中,时间与组之间无显著交互作用。独立样本 t 检验显示,两组在干预前后的基线变量和 X 线结果无显著差异。

结论

本研究发现,与传统康复治疗相比,个体化 BFR 联合传统康复治疗可使 PRWE 评分、握力和腕关节 ROM(尺偏)的增加更为显著。因此,在治疗类似患者时,将个体化 BFR 加入传统康复治疗可能是更好的选择。

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