目的：探讨平衡促进训练方法，并观察其对膝关节前交叉韧带（ACL）损伤重建术后患膝本体感觉的影响。方法选取90例 ACL 损伤重建术后患者，并随机分为两组，每组45例。所有患者均进行12周的术后常规康复训练，术后13周开始。对照组患者采用家庭训练，观察组隔日来我院进行平衡促进训练，术后13、14周进行快速重心转移训练、患肢负重训练、膝关节半屈曲位靠墙下蹲训练、静脉平衡评定训练仪训练，术后14、15周进行靠墙下蹲训练，静态平衡训练由平板过渡到软垫，由睁眼过渡到闭眼，增加折返跑、反向跑、侧方跑等训练。在术后12周及16周末时，采用 PC7012静态平衡功能评定训练系统进行静脉平衡功能评价。采用双极表面电极电刺激髌韧带，记录股内侧肌电图（EMG）。结果治疗16周后，闭眼状态下观察组覆盖90%椭圆区域面积为（408.8±20.0），LFS 指数为（6.4±1.7），对照组分别为（435.5±20.1）mm2，（11.3±1.3），观察组均明显低于对照组（P <0.05）。治疗12周后的睁眼状态和闭眼状态及第16周睁眼状态下，两组患者覆盖90%椭圆区域面积及 LFS 指数差异均无统计学意义（P >0.05）。两组患者术后第12周末时 EMG 无显著差异，在术后第16周末时观察组股内侧肌 EMG 表现明显优于对照组（P <0.05）。结论对 ACL 损伤重建术后患者在采用一般康复训练的同时配合平衡促进训练，可明显改善和恢复患者膝关节的本体感觉能力。%Objective To investigate the balance promotion training method,and observe the effect on knee proprioception after knee joint anterior cruciate ligament(ACL)damage reconstruction. Methods Ninety patients after reconstruction of ACL injury were randomly divided into two groups,with 45 cases in each group. All patients underwent 12 weeks of postoperative conventional rehabilitation training. After 13 weeks of operation,patients in the control group were treated with home training,and patients in the observation group were given balance promotion training every two days. On week 13 and 14 of operation,rapid weight transfer training,limb weight training,knee flexion half wall squat,intra-venous balanced assessment training device training were conducted. And on week 14 and 15,wall squat training,static balance training by a flat transition to cushion the transition from the open eyes closed eyes,increased shuttle run,reverse run were proceeded. On 12th weeks and 16th weekend after surgery, PC7012 static balance training system was used for intravenous balance function evaluation. Surface elec-trodes bipolar stimulating patellar ligament was used to record medial femoral EMG(EMG). Results On 16th weekend after surgery,the elliptical area covering 90% area was(408. 8 ± 20. 0)in the observation group when eyes closed,and LFS index was(6. 4 ± 1. 7)and that of control group was(435. 5 ± 20. 1), (11. 3 ± 1. 3). There were significant differences(P < 0. 05). After 12 weeks of treatment,the state of eyes open or eyes closed and the second 16 weeks eyes open,the elliptical area covering 90% of the area and the LFS index showed no significant difference between the two groups(P > 0. 05). On 12th weekend after surgery,EMG had no significant difference after the first 16 vastus medialis EMG observation group performed which was significantly better than the control group(P <0. 05). Conclusions For the recon-struction of ACL injury patients,balance promotion training combined with the general rehabilitation train-ing can improve and recover the knee joint proprioceptive ability.
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