结合PNF的关节松动术(MWP)技术治疗肘关节功能障碍初探

目的:利用结合神经肌肉促进技术(PNF)的关节松动术(Mobilization with PNF,MWP)技术治疗肘关节骨折术后功能障碍,探讨其对关节主/被动活动度、疼痛、肌肉力量和本体感觉的影响。方法:取2009年8月～2012年4月本院肘关节骨折术后功能障碍患者共32例。患者术后病情稳定,视内固定牢固程度开始康复训练。分为实验组和对照组,对照组患者先常规治疗、关节松动技术、关节牵伸治疗和一般性肌力训练。实验组在以上治疗中,追加MWP治疗替换关节松动术,分别治疗8周后进行功能评价。结果:治疗前后对比,实验组、对照组在关节活动度、视觉模拟(VAS)评分、各肌群肌力方面有明显差异(P<0.01),实验组在位置觉、被动运动觉上有明显差异(P<0.01);治疗后,实验组与对照组在关节活动度、伸肌肌力和旋前肌力上有明显差异(P<0.05),尤其是在屈曲角度、主动旋前角度、VAS评分、位置觉、被动运动觉上差异明显(P<0.01)。结论:MWP对肘关节功能障碍治疗有明显疗效,对肘关节主/被动关节活动度、肌肉力量、本体感觉和疼痛缓解都有促进作用,并优于单纯使用关节松动技术的传统治疗方法。

Study on Effectiveness of Elbow Function Disorder Treated with PNF Combined with MWP

Objective:To study the effectiveness of AROM/PROM,pain,muscle strength and proprioception,and variability during treating dysfunction for elbow by PNF.Methods:To choice 32 patients about dysfunction for elbow fracture from August 2009 to April 2012.When stabilized condition,beginning a rehabilitation,according to firmly degree of internal fixation.And divided randomly into the experimental group(16 cases) and the control group(16 cases).In conventional therapy,all groups exercised by systematic rehabilitation about Joint Mobilization,Joint distraction,and exercise for power and so on,together.In addition to this,the experimental group was treated by Mobilization with PNF(MWP) to replace the mobilization.After 8 weeks,each group had the functional assessment.Results:In the pre and post treatment,and after treatment the difference of the AROM/PROM,the VAS and the power had statistical significance(P<0.01).In the experimental group,the topognosis and the kinesthesia of passive movement had statistical significance(P<0.01).After treatment,the difference of the AROM/PROM,the power of extensor musculature,and pronated musculature,the VAS score between two groups had statistical significance(P<0.05).Especially,the difference of the ROM in flexion,the AROM in the pronated,and the kinesthesia of passive movement had statistical significance between two groups(P<0.01).Conclusion:MWP was effective in treating dysfunction for elbow.The effectiveness of AROM/PROM,relieving pain,muscle strength and proprioception was improved,and was better than tradition therapy with single mobilization.