Application of proprioceptive neuromuscular facilitation on postoperative function recovery in patients after total knee arthroplasty

doi:10.3877/cma.j.issn.2096-0263.2018.04.006

Abstract

Abstract:

Objective

To observe the effect of proprioceptive neuromuscular facilitation (PNF) on functional recovery and walking ability of patients with knee joint after total knee arthroplasty (TKA).

Methods

Fifty patients undergoing elective TKA were randomly divided into two groups (n=25 each), treatment group and control group. Both groups received conventional rehabilitation mainly including rehabilitation education training, muscle strength, range of motion, standing balance training, physical therapy after TKA. The treatment group also applied PNF techniques. Knee function and walking ability of the patients were assessed by the American College of Surgeons Hospital (HSS), the Berg Balance Scale (BBS) and the 6-minute walking test (6MWT) before treatment and after 4 weeks of treatment.

Results

After 4 weeks of treatment, the HSS scores of the treatment group and the control group were (91.6±5.3) and (86.8±4.4) respectively, which were significantly higher than those before treatment (52.7±4.8 and 53.1±4.9), with statistically significance (t=4.126, t=2.722, P<0.01). The scores of functional and stability of the knee after treatment in the treatment group were (19.4±1.3) and (9.1±0.8) points respectively, which were better than those in the control group [(16.2±1.4) and (8.4±1.4)], the differences were statistically significant (t=2.049, t=2.029, P<0.05). The BBS scores of the two groups were (54.4±1.9) and (50.5±2.1)respectively, which were significantly higher than those before treatment [(46.7±3.1) and (46.5±2.2)],with statistically significance (t=2.523, t=2.169, P<0.05). Compared with the control group, the improvement of BBS score in the treatment group was significant (t=2.498, P<0.05). The 6MWT scores of the two groups were (655±51) and (580±56) respectively, which were significantly higher than those before treatment [(397±35) and (402±42)], with statistically significance (t=8.256, t=7.649, P<0.01). Compared with the control group, the 6MWT score of the treatment group improved significantly (t=2.579, P<0.05).

Conclusion

Postoperative patients with TKA in rehabilitation training by using PNF technology can promote knee joint function recovery, improve patient balance function and walking ability.

Key words: Arthroplasty, replacement, knee, Rehabilitation, Proprioception, Proprioceptive neuromuscular facilitation

Zhenglu Yin, Xing Jin, Jijun Huang, Jibing Wang, Kui Wang, Linghui Huang, Zhaoxiang Meng. Application of proprioceptive neuromuscular facilitation on postoperative function recovery in patients after total knee arthroplasty[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2018, 04(04): 219-223.

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References 16

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组别	例数	性别（例，男/女）	年龄（岁，±s）	病侧（例，左/右）	原发病[例（%）]
组别	例数	性别（例，男/女）	年龄（岁，±s）	病侧（例，左/右）	类风湿关节炎	骨关节炎	骨折	其他
治疗组	25	14/11	68±7	13/12	3（12）	14（56）	5（20）	3（12）
对照组	25	15/10	69±7	12/13	2（8）	15（60）	4（16）	4（16）
统计值	?	χ²=0.038	t=0.827	χ²=0.052	χ²=0.039
P值	?	>0.05	>0.05	>0.05	>0.05

组别	例数	性别（例，男/女）	年龄（岁，±s）	病侧（例，左/右）	原发病[例（%）]
组别	例数	性别（例，男/女）	年龄（岁，±s）	病侧（例，左/右）	类风湿关节炎	骨关节炎	骨折	其他
治疗组	25	14/11	68±7	13/12	3（12）	14（56）	5（20）	3（12）
对照组	25	15/10	69±7	12/13	2（8）	15（60）	4（16）	4（16）
统计值	?	χ²=0.038	t=0.827	χ²=0.052	χ²=0.039
P值	?	>0.05	>0.05	>0.05	>0.05

组别	疼痛		t值	P值	功能		t值	P值
组别	治疗前	治疗4 w后	t值	P值	治疗前	治疗4 w后	t值	P值
治疗组	12.2±2.8	27.6±1.8	2.875	0.006	13.3±2.1	19.4±1.3	2.579	0.013
对照组	13.2±2.5	27.9±1.7	2.611	0.012	12.9±2.3	16.2±1.4	2.550	0.014
t值	1.713	1.762	?	?	1.6982.049		?	?
P值	0.093	0.084	?	?	0.0960.046		?	?
组别	活动度		t值	P值	肌力		t值	P值
组别	治疗前	治疗4 w后	t值	P值	治疗前	治疗4 w后	t值	P值
治疗组	7.9±3.5	13.6±2.4	2.695	0.009	7.9±1.6	8.8±1.0	1.934	0.059
对照组	8.1±3.2	13.5±2.3	2.531	0.015	8.0±1.5	8.8±1.2	1.919	0.061
t值	0.390	0.305	?	?	0.239	0.054	?	?
P值	0.698	0.762	?	?	0.812	0.957	?	?
组别	屈膝畸形		t值	P值	稳定性		t值	P值
组别	治疗前	治疗4 w后	t值	P值	治疗前	治疗4 w后	t值	P值
治疗组	6.6±2.2	8.3±1.4	2.297	0.026	5.5±2.4	9.1±0.8	2.209	0.032
对照组	6.7±2.2	8.2±1.3	2.222	0.031	5.4±2.7	8.4±1.4	2.078	0.043
t值	0.181	0.173	?	?	1.171	2.029	?	?
P值	0.857	0.863	?	?	0.865	0.048	?	?

组别	疼痛		t值	P值	功能		t值	P值
组别	治疗前	治疗4 w后	t值	P值	治疗前	治疗4 w后	t值	P值
治疗组	12.2±2.8	27.6±1.8	2.875	0.006	13.3±2.1	19.4±1.3	2.579	0.013
对照组	13.2±2.5	27.9±1.7	2.611	0.012	12.9±2.3	16.2±1.4	2.550	0.014
t值	1.713	1.762	?	?	1.6982.049		?	?
P值	0.093	0.084	?	?	0.0960.046		?	?
组别	活动度		t值	P值	肌力		t值	P值
组别	治疗前	治疗4 w后	t值	P值	治疗前	治疗4 w后	t值	P值
治疗组	7.9±3.5	13.6±2.4	2.695	0.009	7.9±1.6	8.8±1.0	1.934	0.059
对照组	8.1±3.2	13.5±2.3	2.531	0.015	8.0±1.5	8.8±1.2	1.919	0.061
t值	0.390	0.305	?	?	0.239	0.054	?	?
P值	0.698	0.762	?	?	0.812	0.957	?	?
组别	屈膝畸形		t值	P值	稳定性		t值	P值
组别	治疗前	治疗4 w后	t值	P值	治疗前	治疗4 w后	t值	P值
治疗组	6.6±2.2	8.3±1.4	2.297	0.026	5.5±2.4	9.1±0.8	2.209	0.032
对照组	6.7±2.2	8.2±1.3	2.222	0.031	5.4±2.7	8.4±1.4	2.078	0.043
t值	0.181	0.173	?	?	1.171	2.029	?	?
P值	0.857	0.863	?	?	0.865	0.048	?	?

组别	BBS评分（分）		t值	P值	6 MWT（m）		t值	P值
组别	治疗前	治疗4 w后	t值	P值	治疗前	治疗4 w后	t值	P值
治疗组	46.7±3.1	54.4±1.9	2.523	0.015	397±35	655±51	8.256	<0.01
对照组	46.5±2.2	50.5±2.1	2.169	0.035	402±42	580±56	7.649	<0.01
t值	0.157	2.498	?	?	1.911	2.579	?	?
P值	0.876	0.016	?	?	0.062	0.013	?	?

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