智能可穿戴康复系统在膝关节置换术后康复训练中的应用效果

目的 探讨智能可穿戴康复系统在人工全膝关节置换(TKA)术后患者康复训练中的临床应用价值。方法 前瞻性研究。纳入2017年10月—2018年4月在北京博爱医院接受TKA手术治疗的120例患者,其中男51例、女69例,年龄55~78岁,体质量指数(BMI)19.7~32.6 kg/m²,术前膝关节活动度(ROM)84°~117°,K-L分级Ⅲ级42例、Ⅳ级78例。采用随机数法将患者分为对照组60例和康复组60例。住院期间和出院后,对照组患者采用传统遵医嘱、按时复查方式训练,康复组使用NEO-SMART智能可穿戴康复系统辅助进行康复训练。观察两组患者在各随访时间点的膝关节疼痛视觉模拟评分(VAS)、ROM、美国特种外科医院(HSS)膝关节评分。结果 两组患者性别、年龄、BMI、K-L分级比较,差异均无统计学意义(P值均＞0.05)。120例患者中4例失访,其余均获随访6个月。对照组和康复组患者的VAS比较,术后48 h差异无统计学意义(P＞0.05),术后2周和1个月时康复组VAS分别为(2.2±0.61)和(1.2±0.37)分,对照组分别为(2.5±0.82)和(1.7±0.53)分,康复组均低于对照组,差异均有统计学意义(P值均＜0.01);两组患者膝关节ROM比较,术后48 h差异无统计学意义(P＞0.05)。术后 2周、1个月、3个月时分别为88.7°±3.60°和93.1°±3.07°、96.8°±3.76°和103.5°±3.47°、99.8°±4.05°和107.3°±4.33°,差异均有统计学意义(P值均＜0.01);两组患者HSS评分比较,术后1、3、6个月康复组均显著优于对照组(P值均＜0.01)。结论 使用智能可穿戴康复系统可显著提高TKA患者的术后康复训练效果,值得临床推广应用。

Effect of intelligent wearable rehabilitation system on rehabilitation training after knee joint replacement

Objective To explore the clinical application value of intelligent wearable rehabilitation system in rehabilitation after total knee arthroplasty (TKA).Methods Prospective study. The 120 patients from Beijing Boai Hospital treated by TKA from October 2017 to April 2018 were enrolled, including 15 males and 69 females, aged from 55 to 78 years old, body mass index(BMI) from 19.7 to 32.6 kg/m². Preoperative range of motion(ROM) from 84° to 117°, K-L grading Ⅲ 42 patients, Ⅳ 78 patients. The random number method was applied to divide 60 patients into control group and 60 patients into treatment group. During hospitalization and post-discharge, the control group was trained according to the doctor's advice and on-time review, while the treatment group used the NEO-SMART system for postoperative training.The pain visual analogue scale (VAS), knee range of motion (ROM) and knee HSS score of two groups were observed at different time points after surgery.Results There was no significant difference in gender, age, BMI and K-L grading between the two groups(all P values＞0.05). Among the 120 patients, 4 patients were lost in follow-up, others were followed up for 6 months. No significant differences in VAS were noted between two groups at 48 h after operation (P＞0.05). At 2 weeks and 1 month after surgery, VAS in the rehabilitation group was lower than that in the control group (2.2±0.61) and (1.2±0.37) scores in the rehabilitation group and (2.5±0.82) and (1.7±0.53) scores in the control group, respectively, with statistically significant differences (all P values＜0.05). The ROM scores of two groups were not significantly different at 48 h and 1 week after operation (P＞0.05), At 2 weeks, 1 month, and 3 months postoperatively, the knee joint ROM was higher in the treatment group(93.1°±3.07°,103.5°±3.47°,107.3°±4.33°) than the control group (88.7°±3.60°, 96.8°±3.76°, 99.8° ± 4.05°), there were statistical differences(all P values＜0.01). The HSS scores of the treatment group were significantly higher than the control group at 1 month, 3 months and 6 months after surgery (all P values＜0.01).Conclusions Wearable rehabilitation system can significantly improve the effect of rehabilitation training for TKA patients after operation, which is worthy of clinical application.