运动疗法对末期膝关节骨性关节炎患者ADL的影响

目的:研究运动疗法对末期膝关节骨性关节炎(KOA)患者日常生活活动能力(ADL)的影响。方法:将符合入选标准的88例患者,分为3组:无效组为自我评价运动疗法无效而考虑要手术的32例;有效组为自我评价"运动疗法有效"而全程实行的15例;全膝关节置换术(TKA)组为实施全膝关节置换术的41例。以日本版膝关节骨性关节炎功能评价标准(JKOM),visual ana-logue scale(VAS)及upgo test作为评判指标,评价并比较、分析3组的效果。结果:从末期KOA患者的ADL改善来看,JKOM细分类中ADL评价及upgo test的评价表明,在末期KOA运动疗法有效的病例(有效组),其ADL程度与TKA术后(TAK组)几乎是相等的(P0.05);而针对除痛效果,JKOM疼痛及僵硬指标及VAS评判结果表明,TKA组比运动疗法(有效组)更为有效(P0.01)。结论:即使末期KOA,运动疗法对于患者ADL改善,亦是十分有效的,值得积极提倡。

Clinical study of physical therapy for activity of daily living in end stage of knee osteoarthritis

Objective：To observe the clinical effects of physical therapy in end stage Knee Osteoarthritis（KOA） patients＇ ADL（activities of daily living）.Methods：eighty-eight cases of KOA were divided intothree groups,thirty-two patients who thought ＂physical therapy was ineffective and requested to operation＂ were belongs to ineffective group,fifteen patients who thought ＂physical therapy was effective and treated with physical therapy＂ were belongs to effective group,forty-one patients who were taken total knee arthroplasty（TKA） operation belongs to TKA group.All the patients were observed by JKOM,visual analogue scale（VAS） and up go test,after the last follow-up visit to compare therapeutic efficacy of threr groups.Results：according to the appreciation index of JKOM and up go test,there was no difference between effective group and TKA group in inproving patients＇ADL（P0.05）,according to the pain and stiffness index of JKOM,VAS,it seems that TKA group wae more effective in relieving pain and stiffness than effective group（P0.01）.Conclusion：physical therapy is an effective treatment forthe patients with KOA in end stage,especially in inproving patients＇ADL.