中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (33): 6234-6237.doi: 10.3969/j.issn.1673-8225.2010.33.038

• 组织构建临床实践 clinical practice in tissue construction • 上一篇    下一篇

下肢骨折致膝关节功能障碍患者骨密度与早期康复训练的关系

张  琳   

  1. 天津市天津医院康复科，天津市  300000
  • 出版日期:2010-08-13 发布日期:2010-08-13
  • 作者简介:张 琳★，女，1979年生，天津市人，汉族，2008年首都体育学院毕业，硕士，技师， 主要从事体育保健康复理论与实践研究。 lindazhang_79@163.com

Early rehabilitation and bone mineral density in patients with functional disorders of the knee joint caused by lower limb fracture 

Zhang Lin   

  1. Department of Rehabilitation, Tianjin Hospital, Tianjin   300000, China
  • Online:2010-08-13 Published:2010-08-13
  • About author:Zhang Lin★, Master, Technician, Department of Rehabilitation, Tianjin Hospital, Tianjin 300000, China lindazhang_79@163.com

PDF

567

被引次数

37

摘要：

背景：将骨密度检测同康复治疗相关联将有益于患者及康复治疗师及时了解康复进程，为康复治疗师制定或修改康复方案提供更好的依据。但目前国内有关康复治疗对人体骨密度影响的报道相对较少。
目的：观察综合康复训练对下肢骨折致膝关节功能障碍患者骨密度的影响，并比较其性别差异。
方法：选择天津医院康复科下肢骨折致膝关节功能障碍行内固定或外固定患者80例，随机分为康复组与对照组。康复组在术后4周开始进行早期康复治疗，包括主动、被动运动训练及不同物理治疗，持续20周；对照组在术后24周内未进行系统的康复训练。术后4，24周双能X射线检测股骨颈、L 2~4、Ward区骨密度，并测量患者膝关节活动度。
结果与结论：无论是否进行早期运动康复训练及锻炼，下肢制动患者股骨颈、L 2~4以及Ward区骨密度均下降，但康复组与对照组骨密度下降程度不同，康复组各部位骨密度的减少量均低于对照组(P < 0.01)，关节活动增加程度明显大于对照组(P < 0.01)，说明运动康复训练可以有效地减少下肢骨折患者康复期间骨矿物质的丢失，减少局部骨密度下降量，有效预防和改善失用性骨质疏松的情况，并且早期运动康复对下肢骨折所致膝关节功能障碍患者骨密度的影响并无明显的性别差异。

关键词: 下肢骨折, 康复, 膝关节, 功能障碍, 骨质疏松, 双能X射线吸收法, 骨密度, 关节活动度

Abstract:

BACKGROUND: The correlation between bone mineral density (BMD) and rehabilitation treatment benefits understanding the rehabilitation progress, and provides a basis for therapist to establish or correct the program. However, there are few reported regarding the influence of rehabilitative treatment on human BMD.
OBJECTIVE: To investigate the effect of rehabilitation on BMD in patients with functional disorders of knee joint caused by lower limb fracture and compare the gender differences.
METHODS: A total of 80 patients who had the dysfunction of knee joint caused by fracture of lower limb underwent internal or external fixation in Department of Rehabilitation, Tianjin Hospital. They were randomly assigned to rehabilitation and control groups. The rehabilitation group started rehabilitation training at 4 weeks after operation, including active exercise, passive exercise, and various physical therapies for 20 weeks. The control group did not do rehabilitation training during the 24 weeks. At 4 and 24 weeks after operation, the BMD of femoral neck, L 2-4 and ward’s area in two groups was determined by dual energy X-ray absorptiometry, and range of motion of the knee joint was measured.
RESULTS AND CONCLUSION: BMD of femoral neck, L 2-4 and ward’s area in both groups decreased. But the BMD in rehabilitation group was greater than the control group (P < 0.01), and the improvement in range of motion was significantly increased compared with the control group (P < 0.01). The results showed that rehabilitation effectively attenuated bone mineral substance loss during rehabilitation from lower limb fracture, reduced BMD decrease, effectively prevented and improved osteoporosis due to immobilization. Moreover, there were no gender differences.

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