開放式與閉鎖式動力鏈運動對於全膝人工關節置換術患者之成效

Effects of Open and Closed-kinetic-chain Exercises in Patients Following Total Knee Arthroplasty

梁雁秋(Yen-Chiu Liang) ； 邱艷芬(Yann-Fen C. Chao) ； 林寬佳(Kuan-Chia Lin) ； 施信農(Hsin-Nung Shih) ； 林燕慧(Yang-Hwa Lin)

《台灣醫學》 11卷2期 (2007/03) Pp. 130-139

https://doi.org/10.6320/FJM.2007.11(2).02

摘要

The purpose of this study was to evaluate the efficacy of lower limb closed kinetic chain exercise (CKCE) and open kinetic chain exercise (OKCE) in the muscle strength and knee function after total knee arthroplasty (TKA). This was a quasi-experimental, longitudinal clinical study done at a medical center in the northern part of Taiwan. Fifty patients with their consents were randomly and equally divided into either study group or control group. The study group was instructed for CKCE, while the control group was routinely given OKCE. The study instruments included the isokinetic dynamometer and Knee Injury and Osteoarthritis Outcome Score (KOOS). The assessment time points were set at pre-operation, 6 weeks and three months after operation. Data was processed by SPSS 11.0 and the major statistical procedures applied were: descriptive statistics, chi-square test, Student t test and general linear mix-effect model (GLMM). All tests were considered statistically significant at the p＜0.05 level. The isokinetic test results presented significant differences (p＜0.05) between the two groups in the muscle strength of knee flexor muscles at the test speed of 600 per second, 1800 per second, and also in knee extensor muscles at the speed of 1800 per second. It indicated the superior outcome with the intervention of CKCE. The ratio of the two muscles was at the range of 0.49~0.87 for both groups, thus there was no statistically significance (p＞0.05). By using the KOOS to assess knee function, we found different interventions did reveal statistical differences in the daily activities, sports and recreational functions, and life quality (p＜0.05); however, there was no significant difference found in pain and symptoms (p＞0.05). The study results suggest that CKCE can help patient have better knee function after TKA than OKCE.

關鍵字

全膝人工關節置換術 ； 閉鎖式動力鏈運動 ； 開放式動力鏈運動 ； 肌力 ； 膝關節功能

並列摘要

The purpose of this study was to evaluate the efficacy of lower limb closed kinetic chain exercise (CKCE) and open kinetic chain exercise (OKCE) in the muscle strength and knee function after total knee arthroplasty (TKA). This was a quasi-experimental, longitudinal clinical study done at a medical center in the northern part of Taiwan. Fifty patients with their consents were randomly and equally divided into either study group or control group. The study group was instructed for CKCE, while the control group was routinely given OKCE. The study instruments included the isokinetic dynamometer and Knee Injury and Osteoarthritis Outcome Score (KOOS). The assessment time points were set at pre-operation, 6 weeks and three months after operation. Data was processed by SPSS 11.0 and the major statistical procedures applied were: descriptive statistics, chi-square test, Student t test and general linear mix-effect model (GLMM). All tests were considered statistically significant at the p＜0.05 level. The isokinetic test results presented significant differences (p＜0.05) between the two groups in the muscle strength of knee flexor muscles at the test speed of 600 per second, 1800 per second, and also in knee extensor muscles at the speed of 1800 per second. It indicated the superior outcome with the intervention of CKCE. The ratio of the two muscles was at the range of 0.49~0.87 for both groups, thus there was no statistically significance (p＞0.05). By using the KOOS to assess knee function, we found different interventions did reveal statistical differences in the daily activities, sports and recreational functions, and life quality (p＜0.05); however, there was no significant difference found in pain and symptoms (p＞0.05). The study results suggest that CKCE can help patient have better knee function after TKA than OKCE.

並列關鍵字

total knee arthroplasty ； closed kinetic chain exercise ； open kinetic chain exercise ； muscle strength ； knee function