| Objectives: In this study,patients with anterior cruciate ligament reconstruction underwent rehabilitation training and routine rehabilitation training based on the International Classification of Functioning,Disability and Health(ICF)framework.The influence of two rehabilitation training methods on functional recovery of patients was analyzed to provide basis for helping patients to better return to sports and work.Methods: According to inclusion and exclusion criteria,a total of 21 male patients aged 19-37 years who underwent anterior cruciate ligament reconstruction were included and randomly divided into the ICF group(n=11)and the conventional group(n=10).Subjects in the ICF group received rehabilitation training based on the ICF framework,while those in the conventional group received routine rehabilitation training for a total of 6 months.Subjects’ physical structure(10cm suprapatellar circumference was used to assess the degree of atrophy of healthy/affected thigh muscle,anterior cruciate ligament relaxation was assessed by KT1000),physical function(range of motion of affected knee flexor and extensor,muscle strength of affected knee flexor and extensor,and VAS pain scale,respectively,were evaluated before surgery,3 months and 6 months after surgery.Tegner knee activity score and IKDC Knee Assessment Scale),activity and participation(lower limb functional running,pre-agility test,body symmetry jump test,reentry exercise Scale and selfefficacy scale).Repeated measurement variance and multivariate analysis of variance were performed before surgery,3 months after surgery and 6 months after surgery,respectively,to compare the intra-group and inter-group changes in each index before surgery,3 months after surgery and 6 months after surgery.Results:(1)Changes in body structure: In the ICF group,the difference in the healthy-affected side of the 10 cm suprapatellar circumference at 3 months postoperatively and the difference in the healthy-affected side of the circumference and ACL laxity at 6 months postoperatively were better than those in the conventional group(p<0.05).In the ICF group,the difference in circumference of the suprapatellar10 cm decreased at 6 months compared to the preoperative period and at 3 months compared to the preoperative period(P<0.05),and there was no significant difference at 3 months compared to the preoperative period;in the conventional group,there was a significant decrease at 6 months compared to 3 months(P<0.05),and there was no significant difference at 6 months and 3 months compared to the preoperative period(P>0.05).The difference in ACL laxity between the healthy and affected sides of the two groups decreased at 6 months postoperatively compared to preoperatively and at3 months postoperatively(P<0.01),and also showed a decreasing trend at 3 months postoperatively compared to preoperatively(P<0.01).(2)Changes in body function:In the ICF group,at 3 months postoperatively,except for knee flexor muscle strength,VAS pain and IKDC score on the affected side,knee extensor muscle strength,knee mobility in flexion and extension on the affected side and Tegner knee motion score were better than those in the conventional group(P<0.05);at 6 months postoperatively,all indicators of physical function were better than those in the conventional group(P<0.05).A two-by-two comparison between the two groups at different time points showed that the muscle strength of the affected flexor and extensor muscles,the mobility of the affected flexor knee and the Tegner knee motion score were significantly improved in both groups at 6 months postoperatively compared to preoperatively and 3 months postoperatively(P<0.05),while there was no significant difference at 3 months postoperatively compared to preoperatively(P>0.05);the IKDC knee scores in both groups were significantly better at 6 months postoperatively compared to preoperatively and 3 months postoperatively(P<0.05).VAS pain scores were significantly lower in both groups at 6 months postoperatively compared to preoperatively and 3 months postoperatively(P<0.01);there was a significant difference in the ICF group at 3 months postoperatively compared to preoperatively(P>0.05).difference(P<0.05);there was no significant difference in the conventional group at 3 months postoperatively compared with preoperatively.(3)Changes in activity and participation: In the ICF group,at 3 months postoperatively,the single-leg jump,single-leg triple jump,single-leg cross jump,6m timed jump,lower limb functional run,pre agility test and return to exercise scale were all better than those in the conventional group,except for the self-efficacy scale;at 6 months postoperatively,the single-leg jump,single-leg triple jump,single-leg cross jump,lower limb functional run,pre agility test and self-efficacy scale were all better than those in the conventional group,except for the return to exercise scale.All were better than the conventional group.A two-by-two comparison of the two groups at different time points showed that the scores on the single-leg jump,single-leg triple jump,single-leg crossover jump and self-efficacy scales were significantly higher in both groups at 6 months post-operatively compared to pre-operatively and 3 months postoperatively(p<0.01),while there was no significant difference at 3 months postoperatively compared to pre-operatively(p>0.05).Lower limb functional running and return to exercise scale scores were significantly improved in both groups at 6 months post-operatively compared to pre-operatively,3 months post-operatively and 3 months post-operatively compared to pre-operatively(P<0.01).The 6m timed jump was significantly improved in both groups 6 months postoperatively compared to preoperatively and 3 months postoperatively(p<0.01);3 months postoperatively in the ICF group compared to preoperatively(p<0.05);3 months postoperatively in the conventional group compared to preoperatively there was no significant difference.In the pre-agility test,the ICF group showed a significant decrease in time spent at 6months postoperatively compared to preoperative and 3 months postoperative(P<0.05),and no significant difference at 3 months postoperative compared to preoperative(P>0.05);the conventional group showed a significant decrease at 6months postoperative compared to 3 months postoperative(P<0.05),and no significant difference at 6 months postoperative and 3 months postoperative compared to preoperative(P>0.05).Conclusion: Both ICF rehabilitation training and conventional rehabilitation training can improve the body structure,function,activity and participation ability of patients after ACL reconstruction to varying degrees,and the overall rehabilitation effect of ICF rehabilitation training group is better.24 weeks of rehabilitation training based on the ICF framework can structurally adjust the knee ligament relaxation ability.Significantly improve the strength of the knee joint,hip joint,ankle joint and core functionally,enhance the stability of the knee joint and the control of the body movement,improve the range of motion of the knee joint and the walking ability,reduce the pain of the patient,and significantly improve the patient’s jumping ability,moving ability and variable speed steering ability by adjusting the patient’s mental state and increasing professional supervision and guidance.Improve the patient’s motor coordination,balance,response ability,restore the flexibility and flexibility of the body,promote the recovery of body symmetry and specific exercise level,and help the patient better return to family and society,return to sports activities. |
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