| ObjectiveThis project was conducted on patients who had underwent unilateral total knee anthroplasty, an electro-acupuncture under the acupoint-selection principle called "take only Yangming point to treat Wei-flaccidity syndrome" was performed on them, cooperated with rehabilitation training, whose prevention and treatment effect on post-operative disuse antrophy of quadriceps femoris was taken into a clinical research, and its mechanism was discussed so as to seek a control plan more scientific, efficiency, economical and practical.MethodsCases of this research were those of the inpatient subjects from orthopedics ward of Guangzhou Charity Hospital definitely diagnosed with late stage knee osteoarthritis from December 2013 to January 2015, who successfully underwent unilateral total knee anthroplasty.60 cases finally met the research standard then clinical treatment, following-up, statistics and discussion carried on as predesigned. Included cases were divided into two groups randomly, treatment group (group A):3 days after TKA, patients started the combining treatment of electro-acupuncture and quadriceps femoris rehabilitation training, totally 30 cases; control group (group B):patients started just quadriceps femoris rehabilitation training the very day after TKA, totally 30 cases. Statistic analysis were applied on patients from treatment and control groups using their age, gender, distribution of affected extremities and preoperative muscle strength of quadriceps femoris, thigh circumference etc. No statistical significance shown between these two groups (P>0.05), and comparable researchability of them was confirmed.Plan:Treatment group (group A):Quadriceps femoris rehabilitation training initiated following TKA on the same day, electro-acupuncture started the third day after TKA, current frenquency:2.7Hz; wave form:continuous; current intensity:leading to macroscopic muscle contraction of mild extent; time of treatment:20 min each time, qd.30 minutes break and then quadriceps femoris rehabilitation training. Treatment of control group (group B):same point-of-time as group A, only quadriceps femoris rehabilitation training. Data recording:1 day before TKA, postoperative day 14,30,90, and 180, data of patients from two groups were surveyed respectively as the circumference of affected extremities and unaffected ones, muscle strength of quadriceps femoris, and KSS scoring, VASS scoring recorded on postoperative day 1,3, 7,14,30,90, assessing the recovery of knee-joint, clinically and functionally enhancement of knee-joint, and changing status of overall functional recovery of affected extremities. After strict input of data, SPSS 19.0 was then applied in statistic analysis. Difference of these two plans were compared according to the result of the analysis and to make comprehensive analysis and discussion.ResultsCompared to control group, treatment group surpassed it in recovery of quadriceps femoris muscle strength speedy and fortius (P<0.05) during 1 month and 3 months after TKA, also in higher score of KSS comprehensive scoring (P<0.05),3 days and 7days after TKA, lower VAS scoring (P<0.05). Only one case out of the 60 presented fainting during the acupuncture treatment, adverse event never occurred with some adequate rest, and postoperative recovery was well.ConclusionUnder the acupoint-selection principle called "take only Yangming point to treat Wei-flaccidity syndrome", electro-acupuncture combined with rehabilitation training has the following advantages to disuse quadriceps femoris atrophy compared to simple rehabilitation training:(1). More evident early analgesic capacity; (2). Taking less time to restore the atrophic muscle fiber to an fairly condition; (3). In the early and middle stage of rehabilitation, more likely to restore muscle strength of quadriceps femoris to an ideal status within same duration. |
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