[1]雍福娟,付婷婷,斯焱,等.肌内效贴贴扎联合运动疗法在全髋关节置换术后康复治疗中的应用[J].中医正骨,2021,33(03):9-13.
　YONG Fujuan,FU Tingting,SI Yan,et al.Application of kinesio taping therapy combined with exercise therapy to functional rehabilitation after total hip arthroplasty[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(03):9-13.
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肌内效贴贴扎联合运动疗法在全髋关节置换术后康复治疗中的应用()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第33卷
期数:
2021年03期
页码:
9-13
栏目:
临床研究
出版日期:
2021-03-20

文章信息/Info

Title:
Application of kinesio taping therapy combined with exercise therapy to functional rehabilitation after total hip arthroplasty
作者:
雍福娟; 付婷婷; 斯焱; 刘辉; 张鑫
(四川省骨科医院,四川 成都 610041)
Author(s):
YONG Fujuan; FU Tingting; SI Yan; LIU Hui; ZHANG Xin
Sichuan Provincial Orthopedics Hospital,Chengdu 610041,Sichuan,China
关键词:
关节成形术; 置换; 髋;  疼痛; 手术后;  肌内效贴;  运动疗法;  康复
Keywords:
arthroplasty; replacement; hip;  pain; postoperative;  kinesio taping;  exercise therapy;  rehabilitation
摘要:
目的:探讨肌内效贴贴扎联合运动疗法在全髋关节置换术后康复治疗中的应用价值。方法:选择2020年5—12月接受单侧人工全髋关节置换术的患者为研究对象。采用随机数字表将符合要求的患者随机分为2组。运动疗法组自术后第1天开始按照训练方案进行运动疗法治疗,连续训练7 d; 肌内效贴联合运动疗法组在运动疗法治疗基础上,自术后第1天开始肌内效贴贴扎,每2 d更换1次,连续治疗7 d。分别于治疗前和治疗结束后,采用视觉模拟量表(visual analogue scale,VAS)评分评价患者髋关节疼痛程度,采用Harris髋关节评分评价临床疗效,采用日常生活活动能力(activity of daily living,ADL)量表评分评价患者日常生活活动能力,并记录髋关节屈曲、外展及外旋活动度。结果:①分组结果。共纳入91例患者,肌内效贴联合运动疗法组46例,运动疗法组45例。②髋关节疼痛VAS评分。治疗前,2组患者的髋关节疼痛VAS评分比较,组间差异无统计学意义[(3.87±0.76)分,(3.78±0.76)分,t=-0.529,P=0.598]; 治疗结束后,2组患者的髋关节疼痛VAS评分均低于治疗前(t=12.700,P=0.000; t=10.244,P=0.000),肌内效贴联合运动疗法组的髋关节疼痛VAS评分低于运动疗法组[(2.18±0.72)分,(2.33±0.79)分,t=-2.089,P=0.040]。③Harris髋关节评分。治疗前,2组患者的Harris评分比较,组间差异无统计学意义[(38.50±8.72)分,(35.58±7.58)分,t=1.688,P=0.095]; 治疗结束后,2组患者的Harris评分均高于治疗前(t=-13.915,P=0.000; t=-15.356,P=0.000),肌内效贴联合运动疗法组的Harris评分高于运动疗法组[(57.91±7.29)分,(52.60±5.41)分,t=3.942,P=0.000]。④ADL评分。治疗前,2组患者的ADL评分比较,组间差异无统计学意义[(35.44±11.25)分,(32.00±3.44)分,t=1.961,P=0.053]; 治疗结束后,2组患者的ADL评分均高于治疗前(t=-13.866,P=0.000; t=-6.244,P=0.000),肌内效贴联合运动疗法组的ADL评分高于运动疗法组[(68.70±16.88)分,(59.00±12.59)分,t=3.110,P=0.003]。⑤髋关节活动度。治疗前,2组患者的髋关节屈曲、外展及外旋活动度比较,组间差异均无统计学意义(24.02°±14.36°,28.33°±14.06°,t=-1.447,P=0.115; 3.04°±5.11°,3.98°±4.98°,t=-0.885,P=0.379; 3.48°±5.76°,2.22°±4.71°,t=1.137,P=0.259); 治疗结束后,2组患者的髋关节屈曲、外展及外旋活动度均大于治疗前(屈曲活动度:t=-7.647,P=0.000; t=-12.344,P=0.000; 外展活动度:t=-11.709,P=0.000; t=-12.322,P=0.000; 外旋活动度:t=-15.391,P=0.000; t=-13.259,P=0.000),肌内效贴联合运动疗法组的髋关节屈曲活动度大于运动疗法组(51.33°±11.31°,44.38°±6.91°,t=3.527,P=0.001),2组患者的髋关节外展、外旋活动度比较,组间差异均无统计学意义(19.02°±7.43°,16.78°±6.58°,t=1.524,P=0.131; 20.54°±7.17°,18.78°±4.90°,t=1.369,P=0.175)。结论:采用肌内效贴贴扎联合运动疗法对全髋关节置换术后患者进行康复治疗,能够缓解髋关节疼痛,改善髋关节功能,提高患者髋关节活动度和生活活动能力,疗效优于单纯的运动疗法。
Abstract:
Objective:To explore the applied values of kinesio taping therapy combined with exercise therapy in postoperative functional rehabilitation in patients who received total hip arthroplasty(THA).Methods:Ninety-one patients who received unilateral artificial THA from May 2020 to December 2020 were selected as the subjects,and were randomly divided into combination therapy group(46 cases)and exercise therapy group(45 cases)by using random digits table.All patients in the 2 groups were instructed to perform functional rehabilitation exercises according to the training scheme from the postoperative day 1 for consecutive 7 days; moreover,the patients in combination therapy group were treated with kinesio taping therapy from the postoperative day 1 for consecutive 7 days and the kinesio taping were changed every other day.The hip pain degree,clinical curative effects and activity of daily living(ADL)were evaluated by using visual analogue scale(VAS)scores,Harris hip scores and ADL scores respectively before the treatment and after the end of the treatment,and the hip range of motion(ROM)including flexion-extension,abduction and outward rotation was recorded.Results:There was no statistical difference in hip pain VAS scores between the 2 groups before the treatment(3.87±0.76 vs 3.78±0.76 points,t=-0.529,P=0.598).The hip pain VAS scores decreased after the end of the treatment compared to pretreatment in the 2 groups(t=12.700,P=0.000; t=10.244,P=0.000),and were lower in combination therapy group compared to exercise therapy group(2.18±0.72 vs 2.33±0.79 points,t=-2.089,P=0.040).There was no statistical difference in Harris scores between the 2 groups before the treatment(38.50±8.72 vs 35.58±7.58 points,t=1.688,P=0.095).The Harris scores increased after the end of the treatment compared to pretreatment in the 2 groups(t=-13.915,P=0.000; t=-15.356,P=0.000),and were higher in combination therapy group compared to exercise therapy group(57.91±7.29 vs 52.60±5.41 points,t=3.942,P=0.000).There was no statistical difference in ADL scores between the 2 groups before the treatment(35.44±11.25 vs 32.00±3.44 points,t=1.961,P=0.053).The ADL scores increased after the end of the treatment compared to pretreatment in the 2 groups(t=-13.866,P=0.000; t=-6.244,P=0.000),and were higher in combination therapy group compared to exercise therapy group(68.70±16.88 vs 59.00±12.59 points,t=3.110,P=0.003).There was no statistical difference in hip ROM including flexion-extension,abduction and outward rotation between the 2 groups before the treatment(24.02±14.36 vs 28.33±14.06 degrees,t=-1.447,P=0.115; 3.04±5.11 vs 3.98±4.98 degrees,t=-0.885,P=0.379; 3.48±5.76 vs 2.22±4.71 degrees,t=1.137,P=0.259).The hip ROM including flexion-extension,abduction and outward rotation increased after the end of the treatment compared to pretreatment in the 2 groups(flexion-extension ROM:t=-7.647,P=0.000; t=-12.344,P=0.000; abduction ROM:t=-11.709,P=0.000; t=-12.322,P=0.000; outward rotation:t=-15.391,P=0.000; t=-13.259,P=0.000).The hip flexion-extension ROM was greater in combination therapy group compared to exercise therapy group(51.33±11.31 vs 44.38±6.91 degrees,t=3.527,P=0.001).There was no statistical difference in hip abduction and outward rotation ROM between the 2 groups(19.02±7.43 vs 16.78±6.58 degrees,t=1.524,P=0.131; 20.54±7.17 vs 18.78±4.90 degrees,t=1.369,P=0.175).Conclusion:For patients who received THA,combination of kinesio taping therapy with exercise therapy can relieve hip pain,improve hip function,increase hip ROM and promote ADL,moreover,its curative effect is better than that of monotherapy of exercise therapy.

参考文献/References:

[1] 许文.全髋关节置换术治疗髋关节病的疗效观察[D].长春:吉林大学,2014.
[2] 刘法银,项国,田学东,等.快速康复外科理念在全髋关节置换术围手术期的应用[J].中国骨与关节损伤杂志,2015,30(12):1247-1249.
[3] ROBBINS C E,CASEY D,BONO J V,et al.A multidisciplinary total hip arthroplasty protocol with accelerated postoperative rehabilitation:does the patient benefit?[J].Am J Orthop(Belle Mead NJ),2014,43(4):178-181.
[4] 何梅,陈晓莉.康复训练对全髋关节置换术后康复效果的系统评价[J].中国康复医学杂志,2017,32(1):71-77.
[5] WILLIAMS S,WHATMAN C,HUME P A,et al.Kinesio taping in treatment and prevention of sports injuries:a meta-analysis of the evidence for its effectiveness[J].Sports Med,2012,42(2):153-164.
[6] GONZáLEZ-IGLESIAS J,FERNáNDEZ-DE-LAS-PE?S C,CLELAND J A,et al.Short-term effects of cervical kinesio taping on pain and cervical range of motion in patients with acute whiplash injury:a randomized clinical trial[J].J Orthop Sports Phys Ther,2009,39(7):515-521.
[7] MEZZEDIMI C,LIVI W,SPINOSI M C.Kinesio taping in dysphonic patients[J].J Voice,2017,31(5):589-593.
[8] 孙菲,田树峰,杨晨,等.肌内效贴在康复中的应用现状[J].中国运动医学杂志,2019,38(3):235-239.
[9] KUMBRINK B.肌内效贴扎技术指南[M].李清正,安江红,刘勇,译.2版.北京:人民体育出版社,2020:81-210.
[10] 国家卫生计生委公益性行业科研专项《关节置换术安全性与效果评价》项目组,中华医学会骨科学分会关节外科学组,中国医疗保健国际交流促进会骨科分会关节外科委员会.中国髋、膝关节置换术加速康复——围术期管理策略专家共识[J].中华骨与关节外科杂志,2016,9(1):1-9.
[11] 岳寿伟.肌肉骨骼康复学[M].3版.北京:人民卫生出版社,2018:249-254.
[12] 黄晓琳,燕铁斌.康复医学[M].6版.北京:人民卫生出版社,2018:92-101.
[13] 吴明珑,刘洪娟.跨学科护理团队在全髋关节置换患者快速康复中的实践[J].护理学杂志,2016,31(14):96-98.
[14] 白伟侠,卢连君,田晓霞,等.老年人全髋关节置换围手术期快速康复护理[J].中国矫形外科杂志,2020,28(11):928-932.
[15] 刘文辉,覃瑜芳,尹东.快速康复理念在全髋关节置换术的应用研究进展[J].广东医学,2016,37(23):3635-3637.
[16] WILLIAMS S,WHATMAN C,HUME P A,et al.Kinesio taping in treatment and prevention of sports injuries:a meta-analysis of the evidence for its effectiveness[J].Sports Medicine,2012,42(2):153-164.
[17] BALKI S,G?TA �瘙 塁 H E,?TEMUR Z.Kinesio taping as a treatment method in the acute phase of ACL reconstruction:a double-blind,placebo-controlled study[J].Acta Orthop Traumatol Turc,2016,50(6):628-634.
[18] BASSETT K,LINGMAN S,ELLIS R.The use and treatment efficacy of kinesthetic taping for musculoskeletal conditions:a systematic review[J].N Z J Physiother,2010,389(2):56-60.
[19] FERREIRA R,RESENDE R,RORIZ P.The effects of kinesio taping in lower limb musculoskeletal disorders:a systematic review[J].International Journal of Therapies & Rehabilitation Research,2017,6(3):1-13.
[20] BALKI S,G?TAS H E.Short-term effects of the kinesio taping on early postoperative hip muscle weakness in male patients with hamstring autograft or allograft anterior cruciate ligament reconstruction[J].J Sport Rehabil,2019,28(4):311-317.
[21] 刘栎威.肌内效贴扎术对篮排足运动员ACL重建术后早期康复疗效观察[D].北京:北京体育大学,2018.
[22] 刘生发,张锋.肌内效贴结合淋巴引流手法治疗全膝关节置换后下肢肿胀[J].中国组织工程研究,2017,21(11):1647-1651.
[23] DONEC V,KRISCINAS A.The effectiveness of kinesio taping after total knee replacement in early postoperative rehabilitation period.A randomized controlled trial[J].Eur J Phys Rehabil Med,2014,50(4):363-371.
[24] 肖冰,庞杰.肌内效贴扎术对运动员半月板损伤术后早期康复疗效观察[J].南京体育学院学报(自然科学版),2013,12(4):34-35.
[25] 李迅伟,冯彦辉.肌内效贴布辅助治疗对肱骨干骨折患者术后肿胀和疼痛的影响[J].河南医学研究,2020,29(3):445-447.
[26] 郭伏玲,夏文广.肌内效贴联合理疗对股骨干骨折患者术后早期肿胀疗效的观察[J].现代医学与健康研究电子杂志,2018,2(3):30-31.(收稿日期:2021-01-13 本文编辑:吕宁)

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备注/Memo

备注/Memo:
基金项目:四川省医学重点学科(实验室)及重点专科立项建设项目(川卫办发[2018]53号)
通讯作者:张鑫 E-mail:kangfuke2008@163.com
更新日期/Last Update: 1900-01-01