【論文摘要】The Effects of Integrating Exoskeleton-Assisted Gait Training Exercise and Compressive Cryotherapy Into Post-Arthroplasty Physiotherapy-A Pilot Study

【論文摘要】創新整合外骨骼步態訓練和冷循環壓縮法於關節置換術後物理治療中的效果－初步研究

Chia-Yin Lin(林佳吟)

《物理治療》 48卷2期 (2023/06) Pp. 117-118

https://doi.org/10.6215/FJPT.202306.O13

摘要

Background and Purpose: Physiotherapy is a component of post-arthroplasty management. Compressive cryotherapy has been reported to improve pain in total knee arthroplasty (TKA) patients. Although exoskeleton-assisted gait training is increasingly utilized in people with stroke and spinal cord injury, there is lack of evidence about its clinical effectiveness on arthroplasty rehabilitation. Methods: For patients in the study group, we arranged 15 minutes of exoskeleton-assisted gait training on post-operative day one (POD1). Additionally, 30 minutes of compressive cryotherapy was given for three consecutive days since POD1. 30-minutes continuous passive motion (CPM) was applied along with cryotherapy on post-operative day two (POD2). As for the control group patients, conventional post-arthroplasty rehabilitation protocol was followed. The outcome measures were numeric pain-rating scale (NRS), and hip/knee active range of motion (AROM), 30 seconds sit to stand test (30sSST) and 2.44 meters time up and go test (2.44 m TUGT). NRS and AROM were taken on POD1 and on post-operative day three (POD3) after completing the study protocol. 30sSST and 2.44 m TUGT were recorded on POD3. In the study group, the CPM setting angle (CPROM) and NRS were measured before and after the intervention. Results: Six patients were included in the study group and eleven were in the control group. NRS scores (p = 0.027) and time for 2.44 m TUGT (p = 0.01) on POD3 were significantly decreased in the study group than in the control group. However, there were no significant differences in AROM and 30sSST between groups. Compared with applying CPM alone, NRS scores and CPROM on POD2 significantly improved (p = 0.03) after the combination of cryotherapy. Conclusions: This study is the first to investigate the safety, adoptability and efficacy of using an exoskeleton in arthroplasty rehabilitation on POD1. Adding compressive cryotherapy and exoskeleton-assisted gait training to arthroplasty inpatient rehabilitation programs is effective to improve pain and ambulation agility. The combination of cryotherapy and CPM makes patients feel more comfortable and get better immediate ROM outcome. Clinical Relevance: The result of this study can be considered as a first three-day post-arthroplasty protocol.