预康复在前交叉韧带重建术后改善结局中的作用
简介
该研究为前瞻性对照研究，纳入50例ACL重建患者，分为术前康复组（25例）和常规治疗组（25例）。术前康复包括力量、关节活动度、平衡、本体感觉训练及患者教育，术后两组采用相同康复方案。结果显示：术前康复组术前股四头肌力量更优（4.1±0.6 vs. 3.5±0.7），疼痛评分更低（4.2±0.9 vs. 5.1±1.0）；术后6周疼痛显著减轻（2.1±0.7…
英文摘要
INTRODUCTION: Anterior cruciate ligament (ACL) injury is a frequent orthopedic problem which commonly leads to knee instability, loss of function, and delay in recovery. Even though ACL reconstruction (ACLR) is a common procedure, there are significant differences in the results that follow the procedure. Recent data indicate that prehabilitation, which is a rehabilitation performed before surgery, can enhance post-operative outcomes; although its use has not been widely incorporated into clinical practice yet. OBJECTIVES: The objective of the study was to determine the efficacy of structured prehabilitation in enhancing the pain, muscle strength, functional outcomes, range of motion, and early post-operative recovery after ACLR. MATERIALS AND METHODS: A prospective comparative interventional study was done on 50 patients who had primary ACL repair in a tertiary care hospital. The participants were separated into two groups: Group A (n = 25) underwent a structured prehabilitation before surgery, and Group B (n = 25) underwent the usual care that did not involve prehabilitation. Prehabilitation involved strengthening, range-of-motion, balance, proprioception, and patient education. The two groups were subjected to the same post-operative rehabilitation program. Measures of outcomes such as strength of the quadriceps, pain level with the visual analog scale (VAS), knee range of motion, functional outcome scores, time to ambulate independently, and overall post-operative outcome were also evaluated. FINDINGS: The prehabilitation group had better pre-operative quadriceps strength (4.1 ± 0.6 vs. 3.5 ± 0.7) and low pre-operative pain scores (4.2 ± 0.9 vs. 5.1 ± 1.0). During the post-operative period, Group A had a significantly lower pain level at 6 weeks (2.1 ± 0.7 vs. 3.4 ± 0.8) and had a higher knee range of motion (128.5 ± 6.2 vs. 118.3 ± 7.1). The prehabilitation group had more favorable functional outcome scores at 3 months (86.4 ± 5.8 vs. 78.2 ± 6.4). Excellent overall results were more common in the prehabilitation group (72% vs. 40 percent of Group A vs. Group B). CONCLUSION: Pre-operative structured prehabilitation before ACLR is an important factor in the management of pain post-operative, functional outcome, muscle strength, and early mobility. Prehabilitation can be implemented as a part of the standard ACLR care to potentially improve the outcomes of the surgery and recovery of patients.