The Clinical Observation Of Early Functional Rehabilitation By Supine Pedalling Training After Total Knee Arthroplasty

Objective:Compare efficacy between supine pedalling training and continuous passive motion after total knee arthroplasty of early functional rehabilitation. Discuss the application value of supine pedalling training after total knee arthroplasty.Method:Cases are collected from those who were clearly diagnosed with severe KOA and given unilateral total knee arthroplasty for the first time in the Second Department of Orthopaedics, Fuzhou General Hospital of Nanjing Military Command from November 1, 2014 to November 1,2015, where 60 cases are screened out according to standards adopted in this study including 22 males and 38 females, aged 51-81 with an average of 64.39. These cases are randomly divided into test group and control group according to the admission order, each containing 30 cases.With regular functional exercises such as isometric systolic-diastolic motion of quadriceps femoris and hamstring muscles, straight leg raise, active knee flexion-extension, and ankle pump given to both groups during the rehabilitation period, the test group receives additional MOTOmed letto2 rehabilitation system for supine pedalling training in patterns of passive and active assistant exercises as well as active exercises, while the control group receives additional CPM lower limb rehabilitation trainer for continual passive motion. Rehabilitation exercises are conducted on the 2nd after surgery,2 times a day for 30 minutes per session.With reference to hospital for surgery scores scale, visual analogue scale, knee motion range measurement, manual muscle test of muscle strength grading of quadriceps femoris and measured value of horizontal cross-section diameter of kneecap midpoint, the above indexes are recorded on observation points of the admission day and the 4th,8th and 12th day after surgery, and types and doses of additional analgesic drugs applied in the treatment period as well as incision splits, flap margin necrosis and other adverse events are identified and accounted.All the date were analyzed by SPSS18.0 statistical software.Results:The baseline information difference of two group patients like age, gender, body mass index, the distribution of the ill joint, all observed indexes before surgery and adverse reactions after surgery is not statistically significant (P>0.05). On the 8th and 12th day after the surgery, the knee-joint HSS assessment, joint range of motion, pain symptoms improving situation of patients that do supine pedalling training is better than these of patients that continuously do passive exercises (P<0.05). On the 12th day after surgery, the knee-joint circumstance decreasing degree of patients that do supine pedalling training is better than that of patients that continuously do passive exercises (P<0.05). Besides, on the 8th and 12th day after surgery, the recovery of quadriceps femoris muscle strength beside the surgery place of patients that do supine pedalling training is superior to that of patients that continuously do passive exercises (P<0.05).Conclusion:Supine pedalling training with MOTOmed letto2 rehabilitation training system can improve early the motion of knees after total knee arthroplasty, alleviate pain, reduce the swelling and recover the strength of quadriceps femoris muscle, it has therapy meaning to early functional rehabilitation after total knee arthroplasty, and this training mode will not increase complication occurrence conditions, it has safe, effective, intelligent, noninvasive features. supine pedalling training is worthy to be popularized and applied in function rehabilitation after total knee arthroplasty.