摘要
目的探讨渐进性抗阻训练对老年全膝关节置换术后炎症标志物、运动功能和生活质量的影响。方法本研究为随机对照试验。选取在2023年1月至2024年6月在南通大学第六附属医院接受全膝关节置换术的46例≥60岁老年患者,采用计算机随机数法分为试验组和对照组(各23例),对照组给予常规康复管理干预,试验组在对照组的基础上增加渐进性抗阻训练,两组均为期4周。分别于术前1天、术后2周及4周测定两组患者的白细胞介素-6(IL-6)、C反应蛋白(CRP)、红细胞沉降率(ESR)、30 s座椅站立测试(30 s CST)、膝关节社会评分(KSS)、世界卫生组织生活质量测定量表简表(WHOQOL-BREF)评分,并进行对比分析。结果术后2周和4周试验组IL-6、CRP、ESR分别为(22.44±2.17)和(9.91±1.41)pg/ml、(19.61±2.20)和(3.17±0.40)mg/L、(44.85±3.78)和(28.28±3.31)mm/1 h,均低于对照组的(24.65±1.77)和(11.35±1.67)pg/ml、(23.24±2.69)和(4.15±0.45)mg/L、(48.54±3.66)和(34.60±2.98)mm/1 h(均P<0.05);术后2周和4周试验组30 s CST、KSS临床及功能评分分别为(9.87±0.92)和(11.83±1.03)次、(48.44±3.13)和(71.09±3.30)分、(40.44±3.96)和(69.35±4.07)分,均高于对照组的(9.30±0.70)和(10.52±0.79)次、(46.17±2.86)和(67.00±2.89)分、(38.91±3.68)和(66.30±5.05)分(均P<0.05);术后2周试验组WHOQOL-BREF中生理健康、心理健康、社会关系评分分别为(16.96±1.02)、(17.96±1.46)、(6.74±0.62)分,均高于对照组的(16.09±1.08)、(17.14±1.12)、(6.44±0.51)分(均P<0.05),环境条件评分差异无统计学意义;术后4周试验组WHOQOL-BREF中生理健康、心理健康、社会关系、环境条件评分分别为(22.09±1.81)、(22.17±2.19)、(12.09±1.28)、(33.91±2.26)分,均高于对照组的(19.65±1.80)、(20.39±1.95)、(10.17±1.30)、(31.96±2.51)分(均P<0.05)。结论渐进性抗阻训练能够有效地降低老年全膝关节置换术后炎症反应,增强下肢肌力及膝关节功能,改善患者生活质量。
ObjectiveTo investigate the effect of progressive resistance training on inflammatory markers,motor function and quality of life in the elderly after total knee arthroplasty(TKA).MethodsThis study was a randomized controlled trial.A total of 46 elderly patients aged≥60 years who underwent total knee arthroplasty in the Affiliated Hospital 6 of Nantong University from January 2023 to June 2024 were selected and divided into experimental group and control group by computer random number method(23 cases in each group).The control group received routine rehabilitation management intervention,progressive resistance training was added to the experimental group on the basis of the control group,and all patients were intervened for 4 weeks.Interleukin-6(IL-6),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),30-Second Chair Stand Test(30sCST),Knee Society Score(KSS),and World Health Organization Quality of Life Scale-Brief Form Questionnaire(WHOQOL-BREF)scores were measured at 1 day before operation,2 weeks and 4 weeks after operation,and were compared respectively.ResultsAt 2 and 4 weeks after operation,the levels of IL-6[(22.44±2.17)and(9.91±1.41)pg/ml],CRP[(19.61±2.20)and(3.17±0.40)mg/L]and ESR[(44.85±3.78)and(28.28±3.31)mm/1 h]in the experimental group were significantly lower than those in control group[IL-6:(24.65±1.77)and(11.35±1.67)pg/ml,CRP:(23.24±2.69)and(4.15±0.45)mg/L and ESR:(48.54±3.66)and(34.60±2.98)mm/1 h](all P<0.05).At 2 and 4 weeks after operation,the 30sCST[(9.87±0.92)and(11.83±1.03)times],clinical scores of KSS[(48.44±3.13)and(71.09±3.30)points],functional scores of KSS[(40.44±3.96)and(69.35±4.07)points]in the experimental group were significantly higher than those in control group[30sCST:(9.30±0.70)and(10.52±0.79)times,clinical scores of KSS:(46.17±2.86)and(67.00±2.89)points,functional scores of KSS:(38.91±3.68)and(66.30±5.05)points](all P<0.05).At 2 weeks after operation,the scores of physical health,mental health and social relations in the WHOQOL-BREF of the experimental group[(16.96±1.02),(17.96±1.46)and(6.74±0.62)points],which were significantly higher than those in the control group[(16.09±1.08),(17.14±1.12),(6.44±0.51)points](all P<0.05).There was no significant difference in the environmental condition score between the two groups.At 4 weeks after operation,the scores of physical health,mental health,social relations and environmental conditions in WHOQOL-BREF of the experimental group[(22.09±1.81),(22.17±2.19),(12.09±1.28)and(33.91±2.26)points]were significantly higher than those in the control group[(19.65±1.80),(20.39±1.95),(10.17±1.30),(31.96±2.51)points](all P<0.05).ConclusionProgressive resistance training can effectively reduce the inflammatory response in the elderly after total knee arthroplasty,enhance lower limb muscle strength and knee joint function,and improve the quality of life.
作者
郭艮春
董红华
李海凤
朱振华
邵新
徐为峰
Guo Genchun;Dong Honghua;Li Haifeng;Zhu Zhenhua;Shao Xin;Xu Weifeng(Department of Rehabilitation Medicine,Affiliated Hospital 6 of Nantong University(Yancheng Third People′s Hospital),Yancheng 224005,China;Department of Orthopaedics,Affiliated Hospital 6 of Nantong University(Yancheng Third People′s Hospital),Yancheng 224005,China)
出处
《中华健康管理学杂志》
北大核心
2025年第7期536-542,共7页
Chinese Journal of Health Management
基金
南通大学临床医学专项青年项目(2023LQ008)
盐城市重点研发计划(社会发展)指导性项目(YCBE202221)。
关键词
膝关节
人工
康复
骨关节炎
膝
渐进性抗阻训练
炎症标志物
运动功能
生活质量
Knee prosthesis
Rehabilitation
Osteoarthritis,Knee
Progressive resistance training
Inflammatory markers
Motor function
Quality of life
