徒手療法對膝關節攣縮之療效

Effects of Manual Therapy on Knee Contractures Following Surgery

戴英子(Ying-Tsu Tai) ； 周崇頌(Chorng-Sonq Chou) ； 王子娟(Tzyy-Jiuan Wang)

《中華民國物理治療學會雜誌》 19卷2期 (1994/09) Pp. 165-171

https://doi.org/10.29616/JPTAROC.199409.0008

摘要

膝關節受傷在物理治療患者中十分常見，不論是下肢骨折或膝部內外軟組織拉傷或斷裂，經常在癒合的過程中發展出關節攣縮(joint contracture)的問題。臨床上許多方法可用來治療關節攣縮，本文則著重於介紹針對膝關節攣縮病患所設計的徒手療法－關節被動鬆動術(passive joint mobilization)及軟組織按摩法(soft tissue massage)，並探討此一徒手療法之治療效果且分析性別及治療次數對角度增加程度的影響。收集之病患自民國78年至83年間共20位膝關節手術復之病患接受此治療，平均年齡為33±13歲，治療前角度平均為83.0±8.5度，平均接受15.5±8.0次治療，治療結束時之平均角度為137.3±6.7度。平均增加54.3±19.7度，角度進步的情形有統計上意義(P=0.000)。進一步分析增加角度多寡與性別、治療次數或物理治療開始時間於術後30天內或30天後之關係，其結果顯示無統計上的差異。徒手療法固然為耗時費力之治療方式，但一對一的接觸治療不但對患者精神上有支持及關心的作用，與機械牽拉方式相比，更可因實際的接觸而減少不必要的傷害。作者建議臨床採用文中之徒手治療方法，可針對不同膝關節攣縮病患有效地達到治療目的。

關鍵字

膝關節攣縮 ； 徒手療法 ； 關節被動鬆動術 ； 軟組織按摩

並列摘要

Knee Joint contracture is a common problem that physical therapists see in clinics. Many physical therapy interventions have as their goal the restoration of normal joint range of motion (ROM). The purpose of this study was (1) to describe a set of manual therapy which has been recognized as a method for treating knee contracture patients, and (2) to examine the treatment effects of this manual therapy on increasing knee joint RUM. Twenty patients (mean age 33 years, SD=13) following knee surgery were recruited in this study. Their injured knees were treated by an experienced physical therapist using manual therapy including scar mobilization, soft tissue mobilization, and passive joint mobilization. The mean of initial knee RUM at the first physical therapy Key Words: Knee contracture, Manual therapy, Soft tissue mobilization visit was 83.0±18.5 degrees while the mean measure increased to 137.3±6.7 degrees at patient discharge. The average number of therapy visits was 15.5±8.0 with the average gain of knee motion of 54.3±19.7 degrees. This improvement was statistically significant (p=0.000). Effects of gender, number of therapy visits, and the time between surgery and the first physical therapy treatment were assessed. But results showed no significant difference between genders. Neither did the number of visits affect the treatment outcome, nor the time between surgery and the first physical therapy visit. The author concluded that this set of manual therapy is an effective and safe way to treat joint contracture following knee surgery.

並列關鍵字

Knee contracture ； Manual therapy ； Passive joint mobilization ； Soft tissue mobilization