間歇性機械牽拉對膝關節伸直攣縮之療效

在臨床工作上，為了節省人力，彰化秀傳紀念醫院復健科針對膝伸直攣縮之病患，設計一套治療方法－利用臨床所使用之腰部牽引機械，施以間歇性被動牽拉之治療，以增進病患之膝關節彎曲角度。從民國七十年七月到七十六年七月間，共有22名膝伸直攣縮之病患，接受此間歇性機械治療。他們的平均年齡是30.5±10歲，治療前平均角度為39.3±20度，平約接受治療時間為2.2±1.9個月，治療結束時之平均角度為98.4±21.3度，治療後病人平約角度增加59.1±29.92度。治療前膝關節角度等級，3名為良級、19名為差級；治療後膝關節角度等級進步為優級2名、佳級14名、良級4名、差級2名。可看出病人之膝關節角度有明顯之進步。本研究顯示，以間歇性機械牽拉治療膝關節攣縮是頗具療效之治療方法。作者希望未來有更多臨床工作者，期此方向研究，發展出對不同關節攣縮極具效益之治療方法。

關鍵字

膝關節；關節攣縮；物理治療

並列摘要

Prolonged immobilization of a joint results restricted motion, especially the post-operational orthopaedic cases. Physical therapists use the manual passive stretching, hold-relax proprioceptive neuromuscular facilitation and joint mobilization techniques to improve the range of motion. All of the techniques are manual therapy, taking the high cost of man power. From the cost-effective point of view, using pulley or suspension system as passive continuous stretching therapy was applied on these cases for years. Clinically, intolerable pain and involuntary contraction do occur during the treatment and hinder the improvement. For overcoming those disadvantages of therapy, the author took the electrical pelvic traction machine as the external force and provided a slow, smooth and intermittent passive stretching from the traction unit. From July 1981 to July 1987 at SHM hospital, 22 cases were treated by this method for knee extension contracture in this study. The mean age was 30.5±10 years old. The mean treatment duration was 2.2±1.9 months. Before treatment 3 patients were in fair grade and 19 patients in poor grade according to range of motion of knee. After treatment, 2 patients were in excellent grade, 14 patients in good grade, 4 patients in fair grade and 2 patients in poor grade. The mean initial range of motion at the beginning of the treatment was 39.3±20 degrees, the final range of motion was 98.4±21.3 degrees and the mean gain of range at the end of treatment was 59.1±29.9 degrees. Using a two-tailed paired t-test to examine the results, and the difference was significant at the 0.01 level. We found a significant difference between mean value of initial and final range of motion (p=0.000). The lesion sites, casting or not, and the time to receive physical therapy had no significant effects on the results of treatment. This study provided a new appraoch to management of knee extension contracture and it is also proved to be an effective, convenient and less man power choice in the clinics.

並列關鍵字

Knee ； Contracture ； Physical therapy

國際替代計量

間歇性機械牽拉對膝關節伸直攣縮之療效

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