The Effect Of Isokinetic Exercise In The Early Rehabilitation Of Postoperative Fracture Of The Elbow

Objective:To explore the effect of early systematic rehabilitation with isokinetic exercise device for patients with postoperative fracture of the elbow. To compare the curative effect of elbow functional recovery of patients with postoperative fracture of the elbow treated in between the isokinetic therapeutic schedule and traditional rehabilitation schedule. To explore a practical and effective isokinetic rehabilitation program.Methods:From Jan 2009 to Oct 2010,30 patients with elbow fractures underwent open reduction and internal fixation.15 cases randomly selected were treated in early systematic rehabilitation with isokinetic exercise device; they underwent isokinetic continuous passive motion within painless for 30 minutes every day from 4-5 days of postoperation and an additional isokinetic strength training from 10 to 20 minutes daily from 7-10 days of postoperation; from 12-14 days of postoperation, the isokinetic continuous passive motion was done 30 minutes every morning to improve the range of motion and the isokinetic strength training was done 30 minutes every afternoon, both of which were done for 4 days per week, and 2 weeks as a course of treatment, last 3 courses of treatment.15 cases were randomly selected as control group, then took functional rehabilitation exercises in the light of guidance of the physician. They underwent elbow passive activity for 30 minutes daily from 4-5 days of postoperation and an additional progressive resistance training from 10 to 20 minutes daily from 7-10 days of postoperation. From 12-14 days of postoperation, the elbow mobilization was done 30 minutes every morning and the progressive resistance training was done 30 minutes every afternoon, both of which were done for 4 days per week, and 2 weeks as a course of treatment, last 3 courses of treatment. In the final,13 cases were followed up for 6 months. Before rehabilitation and at 4 weeks,8 weeks,6 months of postoperation, the elbow flexion,extension,pronation and supination activity were respectively measured and the elbow function was respectively evaluated by Mayo elbow score. The obtained datas were statistically analyzed.Results:28 patients were followed up for 6 months. Both of groups were significantly improved in the Mayo eLbow score and the elbow flexion,extension,pronation and supination activity(P<0.05). The isokinetic group were significantly better than the control group in the Mayo scores and elbow joint activity (P<0.05) both 4 weeks and 8 weeks later; the efficient of two groups were 100% after 6 months, the patients of isokinetic rehabilitation group had no loosening of internal fixation, fracture healing or disuse osteoporosis.Conclusion:①The isokinetic exercise device is used in the early rehabilitation of Patients with postoperative fracture of the elbow, can significantly improve the function of the elbow and accelerate recovery process.②The isokinetic testing can be provided objective and accurate data for drafting more rational and individualized training mode; The isokinetic training with good security is more efficient recovery for limb function.③The rehabilitation, in the light of guidance of physician, is an effective way to improve elbow function. Although it is slower than isokinetic in improving muscle strength and elbow joint activity in the early days, it is still a popularization of rehabilitation.