智能训练系统在全膝关节置换术患者围术期康复训练中的应用：一项前瞻性随机对照研究-中华老年骨科与康复电子杂志

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Title:: Application of intelligent training system in perioperative rehabilitation training for patients undergoing total knee arthroplasty: A prospective randomized controlled study

作者:: 韩媛媛张泽薛庆云闫蕾常琳石磊; 100730 北京医院骨科，国家老年医学中心，中国医学科学院老年医学研究院

Author(s):: Han Yuanyuan; Zhang Ze; Xue Qingyun; Yan lei; Chang Lin; Shi Lei.; Department of Orthopedics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China

关键词:: 全膝关节置换; 智能训练系统; 康复; 随机对照试验

Keywords:: Total knee arthroplasty; Intelligent training system; Rehabilitation; Randomized controlled trial

DOI:: 10.3877/cma.j.issn.2096-0263.2025.05.005

文献标志码:: A

摘要:: 目的观察智能训练系统在全膝关节置换患者围手术期康复过程中实施效果。方法开展一项前瞻性随机对照试验，连续收集北京医院骨科2023年12月至2024年7月收治的40例全膝关节置换术的患者，男性13例，女性27例，平均年龄（70.40±6.22）岁。采用随机数表法，分为对照组与试验组，各20例。对照组给予常规康复训练指导，试验组在常规康复的基础上应用智能训练系统进行康复训练，对比两组在膝关节功能、膝关节活动度、首次下地时间、锻炼依从性、日常生活活动能力、护理满意度以及疼痛情况。结果试验组和对照组在术后各时间点的HSS、膝关节活动度、Barthel指数、NRS疼痛评分进行了重复测量设计的方差分析显示，不同组别间差异均有统计学意义（P＜0.001），与对照组相比试验组术后4天及6周膝关节功能评分更高（P＜0.001），术后第1天、第4天及6周的膝关节活动度更大（P＜0.001），术后4天及6周的日常生活活动能力评分更高（P＜0.001），且术后1至4天及术后6周疼痛评分更低（P＜0.05）。组别与时间点间均存在显著的交互作用（P＜0.001），试验组在术后各时间点间差异均有统计学意义。此外，试验组的锻炼依从性、首次下床时间及护理满意度均显著优于对照组（P＜0.001）。结论智能可穿戴训练系统在全膝关节置换术围手术期的应用效果显著，能有效提高康复效果，值得临床广泛应用及推广。

Abstract:: Objective To observe the implementation effect of an intelligent training system in the perioperative rehabilitation of patients undergoing total knee arthroplasty (TKA). Methods A prospective randomized controlled trial was conducted. A total of 40 patients who underwent TKA in the Department of Orthopedics, Beijing Hospital, from December 2023 to July 2024, The cohort consisted of 13 males and 27 females, with a mean age of 70.40±6.22 years. Using a random number table, patients were allocated to either the control or experimental group, with each group consisting of 20 patients. The control group received standard rehabilitation training, while the experimental group received rehabilitation training based on an intelligent training system in addition to conventional rehabilitation. Outcomes compared between the two groups included knee joint function, range of motion (ROM), adherence to rehabilitation training, first ambulation time, activities of daily living (ADL), nursing satisfaction,and pain levels. Results Repeated measures analysis of variance for HSS scores, ROM, Barthel Index, and NRS pain scores at various postoperative time points indicated statistically significant differences between the groups (P<0.001). Compared with the control group, the experimental group showed higher knee function scores at 4 days and 6 weeks postoperatively (P<0.001), greater knee range of motion at postoperative days 1, 4, and 6 weeks (P<0.001), higher activities of daily living scores at postoperative days 4 and 6 weeks (P<0.001), and lower pain scores from postoperative days 1 to 4, as well as at 6 weeks (P<0.05). Significant interactions between group and time point were observed (P<0.001), with statistically significant differences noted across all postoperative time points in the experimental group. Furthermore, the experimental group showed significantly superior exercise compliance, time to first ambulation, and nursing satisfaction compared with the control group (P<0.001). Conclusion The intelligent wearable training system demonstrates significant efficacy in perioperative rehabilitation for TKA patients, effectively improving rehabilitation outcomes and warranting widespread clinical application and promotion.

中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

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