The effectiveness of a pre-operative home-based physiotherapy programme for chronic anterior cruciate ligament deficiency
The effectiveness of a pre-operative home-based physiotherapy programme for chronic anterior cruciate ligament deficiency
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DOI：
10.1002/pri.341
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发表时间：
2006-12-01
影响因子：
1.7
通讯作者：
Bullock, M. I.
中科院分区：
文献类型：
--
作者：
Keays, S. L.;Bullock-Saxton, J. E.;Bullock, M. I.
背景和目的。很少有证据支持术前康复治疗慢性前交叉韧带缺陷（ACLD）受试者的处方。本研究的目的是评估ACLD膝关节术前6周特定运动计划的有效性。法设计了一项单盲对照研究。这包括两个匹配的组12慢性ACLD患者等待重建和一组12匹配的未受伤的对照组。只有一个ACLD组接受了家庭锻炼和教育方案。运动干预前后的评估包括：膝关节稳定性（临床和KT 1000评估）;肌肉力量（Cybex II）;站立平衡和功能表现（敏捷性，跳跃和主观测试）。结果在初始评估时，两个ACLD组的任何测量结果均无统计学显著差异，但两个ACLD组在股四头肌力量和功能方面与未受伤对照组存在显著差异。六周后进行的测量显示，未治疗的ACLD组或未受伤的对照组均无显著改善。治疗的ACLD组在以下测量中显示出显著改善：以每秒60度和120度测量的股四头肌力量（p < 0.001）;单腿闭眼站立平衡（p < 0.001）; 20 lb（89 N）力下的仪器被动稳定性（p = 0.003）;敏捷性和主观表现（p < 0.001）。ACLD治疗组不稳定发作的发生率降低，减少了对关节的进一步损伤。结论这项研究几乎没有留下任何疑问，术前物理治疗对ACLD受试者的运动功能有积极的影响，应常规处方，以最大限度地提高重建前的肌肉稳定潜力。患者报告稳定性改善，在某些情况下，可以避免手术。运动增加关节被动稳定性的发现是出乎意料的，需要进一步调查。(C))2006年约翰威利父子有限公司
Background and Purpose. Little evidence supports the prescription of preoperative rehabilitation in the treatment of chronic anterior cruciate ligament-deficient (ACLD) subjects. The aim of the present study was to assess the effectiveness of a specific six-week pre-operative exercise programme on ACLD knees. Method. A single, masked, controlled study was designed. This comprised two matched groups of 12 chronically ACLD patients awaiting reconstruction and a group of 12 matched uninjured control subjects. Only one ACLD group received a home-based exercise and educational programme. Assessment before and after the exercise intervention included: knee joint stability (clinical and KT1000 evaluation); muscle strength (Cybex II); standing balance and functional performance (agility, hop and subjective tests). Results. At the time of initial assessment there were no statistically significant differences in any measures for the two ACLD groups but both ACLD groups were significantly different from the uninjured control group as regards quadriceps strength and function. Measures taken after six weeks showed no significant improvement in the untreated ACLD group or in the uninjured control group The treated ACLD group showed significant improvement in the following measures: quadriceps strength measured at 60 degrees and 120 degrees per second (p < 0.001); single leg standing balance with eyes closed (p < 0.001); instrumented passive stability at 20lb (89N) force (p = 0.003); agility and subjective performance (p < 0.001). The incidence of unstable episodes had decreased in the treated ACLD group, reducing further damage to the joint. Conclusion. This study leaves little doubt that pre-operative physiotherapy had a positive effect on motor function in ACLD subjects and should be prescribed routinely to maximize muscle stabilizing potential prior to reconstruction. Patients report improved stability and, in certain cases, may avoid surgery. The finding that exercise increased the passive stability of the joint was unexpected and requires further investigation. (C)) 2006 John Wiley & Sons, Ltd.