| Objective and purpose:This subject uses routine training,electro acupuncture combined with routine training and electro acupuncture combined with isokinetic training to observe the clinical effect of these three different methods of treatment in postoperative rehabilitation after knee osteoarthritis(KOA)arthroscopic debridement,in order to explore the important role of electro acupuncture combined with isokinetic training in the improvement of knee joint pain,muscle function and joint function in postoperative patients,clarify its treatment mechanism and provide a safe and effective postoperative rehabilitation program of integrated traditional Chinese and Western medicine treatment for arthroscopic debridement.Method:The selected cases were from patients who underwent KOA arthroscopic debridement at the department of Orthopedics Center in Beijing University of Chinese Medicine Third Affiliated Hospital from November 2017 to January 2019.A total of 75 patients met the inclusion criteria and were selected as subjects.They were randomly divided into three groups of 25 patients:control group(routine training),observation group 1(electro acupuncture combined with routine training)and observation group2(electro acupuncture combined with isokinetic training).All patients underwent conventional symptomatic treatment and two weeks of routine training after arthroscopic surgery.The intervention began on the 15th day after surgery.The control group continued routine training.The observation group1 was treated with electro acupuncture on the basis of the control group.The observation group 2 was treated with electro acupuncture treatment and isokinetic training.Routine training and isokinetic training were performed once a day,electro acupuncture treatment was performed every other day and three times per week for a total of four weeks.The changes of Visual Analogue Scale(VAS),Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)and knee Joint isometric test index[Range of Motion(ROM),Peak Torque(PT)and Work Fatigue(WF)of flexor and extensor groups,Flex/Extension(F/E)]in the three groups before and after the intervention were observed and recorded,and the clinical effects were evaluated and analyzed.Result:1)The gender,age,height,weight,body mass index,disease duration,Kellgren-Lawranee(KL)X-ray classification,VAS score,WOMAC osteoarthritis index score and isokinetic test indicator(ROM,PT,WF,F/E)of the three groups before treatment were not statistically significantly different,therefore the clinical baseline data were comparable.2)VAS scores:VAS scores were significantly improved in the three groups before and after intervention(P<0.05).After the intervention,the observation group 1 and the observation group 2were superior to the control group and the difference was statistically significant(P<0.05);there was no statistical difference between observation group 1 and observation group 2(P>0.05).The result indicating that the electro acupuncture has significant relief effect on knee joint pain after arthroscopy.3)Isokinetic test indicator-ROM,PT,WF:ROM and the PT and WF values of flexion and extension muscles of knee joints were significantly improved in the three groups before and after intervention(P<0.05);After the intervention,observation group 1 and observation group 2 were superior to the control group and the difference was statistically significant(P<0.05,P<0.01).Observation group 2 was better than observation group 1 and the difference was statistically significant(P<0.05).It shows that both electro acupuncture and isokinetic training can improve the muscle strength and endurance of flexion and extension muscles of knee joints and knee joint ROM.The combination of electro acupuncture and isokinetic training can significantly improve the clinical efficacy.4)Isokinetic test indicator-F/E:Compared with the three groups before and after intervention,the F/E ratio of the control group and the observation group 1 was lower than that before the intervention and the difference was statistically significant(P<0.05),the F/E ratio of the observation group 2 were higher than that before the intervention and the difference was statistically significant(P<0.05).There was no significant difference between the control group and the observation group 1 after the intervention(P>0.05).The observation group 2 was superior to the control group and observation group 1 and the differences were statistically significant(P<0.05).It shows that isokinetic training is superior to conventional muscle strength training in restoring the balance of flexion and extension muscles of knee joints and increasing j oint stability.5)WOMAC Osteoarthritis Scale score:The total score and the sub-project pain,stiffness and daily living ability scores were significantly improved in the three groups before and after intervention(P<0.05);After the intervention,as for the total score,stiffness and daily life ability score,observation group 1 and observation group2 were superior to the control group and the difference was statistically significant(P<0.05,P<0.01).Observation group2 was better than observation group 1 and the difference was statistically significance(P<0.05);As for score,observation group 1 and observation group2 were better than the control group and the difference was statistically significant(P<0.05);There was no statistical difference between observation group 1 and observation group2(P>0.05).The result indicates that both electro acupuncture and isokinetic training can significantly improve the knee function of patients after arthroscopy.The combination of electro acupuncture and isokinetic training is more significant than the conventional training mode.Conclusion:1)Electro acupuncture is effective in relieving pain after arthroscopy.Combined with rehabilitation training,it can effectively improve the muscle strength and endurance of flexion and extension muscles of knee joints and knee joint function.2)Isokinetic training can effectively improve the the muscle strength and endurance of flexion and extension muscles of knee joints and its balance after KOA arthroscopy,and effectively improve knee function.3)Compared with the traditional KOA arthroscopic postoperative rehabilitation mode,the electro acupuncture combined with constant isokinetic training mode can significantly relieve postoperative pain,improve muscle strength and improve joint function.It is a safe and effective postoperative rehabilitation program of integrated traditional Chinese and Western medicine treatment for arthroscopic debridement. |
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