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膝关节置换术后的初级保健康复——一项横断面研究

Primary care rehabilitation after Knee Replacement - a cross sectional study.

作者信息

Östlind Elin, Ljung Marcus, Ståhl Caroline, Cronström Anna, Jönsson Thérèse

机构信息

Department of Health Sciences, Lund University, Lund - Sweden.

Dalby Healthcare Centre, Dalby - Sweden.

出版信息

Arch Physiother. 2025 Jul 3;15:184-191. doi: 10.33393/aop.2025.3405. eCollection 2025 Jan-Dec.


DOI:10.33393/aop.2025.3405
PMID:40612497
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12224693/
Abstract

BACKGROUND: Rehabilitation after Knee Replacement (KR) surgery often entails an extensive rehabilitation in primary care but evidence-based high-quality guidelines are lacking. There is also a knowledge gap regarding current rehabilitation modalities applied in primary care in Sweden. This study aimed to (I) describe rehabilitation in primary care after KR and (II) explore physiotherapists' perceptions of patients' challenges during the rehabilitation. METHODS: A cross-sectional, web-based survey was conducted among Swedish physiotherapists working in primary care. Questions were categorical or open-ended and related to current rehabilitation practices, treatment modalities, and physiotherapists' perceptions of patients' challenges in rehabilitation after KR. Data were described descriptively and open-ended answers were analyzed with quantitative and qualitative content analysis. RESULTS: In total, 202 physiotherapists answered the survey. Rehabilitation focused on home exercises with recurrent physiotherapy visits. Common treatment modalities were knee range of motion exercises, strength training, and stationary cycling. Key rehabilitation challenges included the following categories: , , and . CONCLUSION: Rehabilitation after KR in Swedish primary care seems to be in line with previously recommended international treatment modalities. According to the physiotherapists in this study, some of the key challenges that patients faced were not being prepared for the severe pain regaining function and trust in the knee, balancing load/recovery, and resuming physically demanding activities.

摘要

背景:膝关节置换术(KR)后的康复通常需要在初级保健机构进行广泛的康复治疗,但缺乏基于证据的高质量指南。瑞典初级保健机构目前应用的康复方式也存在知识差距。本研究旨在(I)描述KR术后初级保健机构的康复情况,以及(II)探讨物理治疗师对患者康复过程中面临挑战的看法。 方法:对瑞典从事初级保健工作的物理治疗师进行了一项基于网络的横断面调查。问题为分类问题或开放式问题,涉及当前的康复实践、治疗方式以及物理治疗师对KR术后患者康复挑战的看法。数据采用描述性方法进行描述,对开放式回答采用定量和定性内容分析。 结果:共有202名物理治疗师回答了调查。康复重点是家庭锻炼以及定期的物理治疗门诊。常见的治疗方式包括膝关节活动度练习、力量训练和固定自行车运动。关键的康复挑战包括以下几类: , ,以及 。 结论:瑞典初级保健机构中KR术后的康复似乎与先前推荐的国际治疗方式一致。根据本研究中的物理治疗师的说法,患者面临的一些关键挑战包括对严重疼痛没有做好准备、恢复膝关节功能和信心、平衡负荷/恢复以及恢复体力要求较高的活动。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba54/12224693/fdf374649f14/aop-15-184_g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba54/12224693/fdf374649f14/aop-15-184_g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba54/12224693/fdf374649f14/aop-15-184_g001.jpg

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本文引用的文献

[1]
Predictive Validity of the Work, Osteoarthritis, or Joint Replacement Questionnaire for Return to Work After Total Knee Arthroplasty: A 12-Month Multicenter Prospective Cohort Study.

J Arthroplasty. 2025-3

[2]
Comparative long-term outcomes of unicompartmental and total knee arthroplasty in knee osteoarthritis patients: a systematic review and meta-analysis.

Front Surg. 2024-8-21

[3]
Long-term gait analysis in patients after total knee arthroplasty: A systematic review and meta-analysis.

Gait Posture. 2024-9

[4]
EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis: 2023 update.

Ann Rheum Dis. 2024-5-15

[5]
What's important for recovery after a total knee replacement? A systematic review of mixed methods studies.

Arch Orthop Trauma Surg. 2024-5

[6]
Projections and Epidemiology of Primary Hip and Knee Arthroplasty in Medicare Patients to 2040-2060.

JB JS Open Access. 2023-2-28

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Core Recommendations for Osteoarthritis Care: A Systematic Review of Clinical Practice Guidelines.

Arthritis Care Res (Hoboken). 2023-9

[8]
The course of knee extensor strength after total knee arthroplasty: a systematic review with meta-analysis and -regression.

Arch Orthop Trauma Surg. 2023-8

[9]
Objective monitoring of functional recovery after total knee and hip arthroplasty using sensor-derived gait measures.

PeerJ. 2022

[10]
Rehabilitation for Total Knee Arthroplasty: A Systematic Review.

Am J Phys Med Rehabil. 2023-1-1

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