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Objective To determine the intra-and inter-tester reliability of a dynamometer in assessment of knee joint position senses (JPS).Methods Sixteen healthy volunteers (intra-rater N =6,inter-rater N =10) were examined with regard to intra-and inter-tester reliability of knee JPS by using Biodex System 3 dynamometer,measured by passive replication test,with subjects passively returning to the initial positions at 30°,45° and 60° knee flexion.The absolute error (AE) angle was recorded.Both intra-and inter-tester reliability studies involved two testers.Results The intra-tester reliability of the AE were moderate reliable at 30°,45°and 60° knee flexion,and the values of intra-class correlation coefficients (ICC) were 0.728,0.780 and 0.807,respectively.The values of Pearson's correlation coefficients for inter-tester reliability were 0.676,0.610 and 0.705,respectively (P ＜ 0.05).There was no significant difference between the AE values of dominance and non-dominant knees,test and retest,and in the AE values of 30°,45°and 60° knee flexion (P ＞ 0.05).The 95％ confidence upper limits of all subjects' AE values were less than 3°.Conclusion The major findings of this study suggest that the test-retest reliability of the knee JPS were moderate using Biodex System 3 dynamometer,and selecting a target angle of passive replication test can achieve the same purpose in 30° to 60°knee flexion.The clinical significance should be taken into consideration when the AE changes were greater than 3 degrees.
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Objective To observe and compare the functional outcomes of early rehabilitation of persons who received primary bilateral or unilateral total knee arthroplasty (TKA).Methods Sixty-eight subjects were divided into a unilateral TKA group (36 cases) and a bilateral TKA group (32cases).All received the same professional rehabilitation program during an average postoperative hospital stay of (15.00 ± 3.71 ) days.At discharge,a visual analogue scale (VAS) was used to rate pain.Active range of motion (AROM) of the involved knee,knee injury and an osteoarthritis outcome score (KOOS) were also assessed.The KOOS and knee society score (KSS) were evaluated at follow-up about 11 months later.Results There was no significant difference between the two groups in any assessment at discharge,nor in the KOOS and KSS-Ⅰ assessments at follow-up.The KOOS of both groups at follow-up had improved significantly compared with that at discharge.The KSS-Ⅱ results in the bilateral group were slightly better than those in the unilateral group at follow-up,and that difference was significant.Conclusions Bilateral TKA patients and unilateral TKA patients had the same clinical outcomes after early postoperative rehabilitation,but the functional outcomes of bilateral TKA patients were better than those of unilateral TKA patients a year later.
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BACKGROUND: Early rehabilitation following total knee replacement has arisen more attention. The aim of continuous passive joint motion is to recover knee function, prevent anchylosis, accelerate blood and synovia circulation, therefore, enhance tissue repair. OBJECTIVE: To evaluate the efficacy of continuous passive joint motion following total knee replacement. METHODS: Totally 48 patients, who underwent artificial total knee arthroplasty at the Department of Orthopedics, Center Hospital of Minhang District, Shanghai Ruikang Hospital Group and Department of Rehabilitation Medicine, 309~(th) Hospital of Chinese PLA between December 2007 and October 2009 were selected. The patients were randomly divided into the experimental and control groups, with 24 cases in each group. The isometric contraction of qudraceps muscles, combined with physical agent assistant, was performed prior to total knee replacement. Patients in the experimental group was received continuous passive joint motion training at day 2 after operation, with 5°-10°increasing per day. Patients in the control group were treated with conventional methods. The knee functional score, and visual analog scale (VAS) was performed to evaluate knee functions and pains, in addition, perimeter between two legs; and range of motion were measured. RESULTS AND CONCLUSION: The knee functional score, VAS, perimeter between two legs, and range of motion were similar prior to and after total knee replacement (P > 0.05). Compared to the control group, the knee functional score of the experimental group was dramatically increased at days 3 and weeks 2 after operation (P < 0.01), the VAS and perimeter between two legs were significantly declined (P < 0.01), the range of motion was obvious improved after replacement, with greater excellent rate (P < 0.01). There was no deep venous thrombosis or infections. The results demonstrated that early rehabilitation following knee replacement is conductive to easing pain, eliminating swelling, and enhancing knee stability.
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@#目的探讨间歇性气压治疗在下肢创伤早期康复中消除肿胀的作用。方法将 65例患者分为对照组和治疗组。对照组33例,采用常规康复治疗。治疗组32例,在采用常规康复治疗同时进行间歇性气压治疗。结果治疗组患肢肿胀及疼痛程度减轻明显优于对照组。结论下肢创伤患者在康复过程中配合间歇性气压治疗减轻肿胀和疼痛,对促进患者配合早期运动起着积极作用。