背景:踝关节骨折术后肢体功能的恢复是一个渐进的过程。实施早期功能锻炼的主要目的,联合机动性,肌肉收缩功能,被动踝关节屈伸练习,或物理因素治疗技术是实现肢体正常生理功能的快速恢复。然而,目前最有效的康复训练方法是阶段性肢体功能锻炼,促进肢体功能的快速恢复,同时防止过度劳累或训练不足造成的不良后果。阶段性肢体功能锻炼将康复过程分为多个阶段,每个都有具体的培训目标和内容。这种方法有助于患者逐渐恢复肢体功能。然而,一些患者在标准化运动后仍表现出不良的肢体功能。因此,应进行功能评估,以分析踝关节骨折手术后分期功能训练的影响。
目的:对踝关节骨折患者进行功能评估并确定阶段性功能训练的影响因素。
方法:一项回顾性研究纳入了2020年5月至2022年5月在我院接受手术治疗的150例踝关节骨折患者。对一般数据进行单变量和多元线性回归分析,骨科患者功能锻炼依从性量表,社会支持评定量表(SSRS),美国矫形外科足踝评分(AOFAS)踝足-足足评分,和疼痛因素[血清缓激肽(BK),前列腺素E2(PGE2),5-羟色胺(5-HT)]。
结果:基于AOFAS踝足量表,分为功能优异组(n=111)和功能普通组(n=39)。单因素分析显示,家庭月收入,教育水平,糖尿病,骨科患者功能锻炼依从性量表评分,SSRS,BK,PGE2、5-HT对踝关节骨折后肢体功能有显著影响(P<0.05);多元线性回归分析显示,SSRS,BK,PGE2、5-HT是影响阶段性功能锻炼后功能表现的独立危险因素(P<0.05)。
结论:运动依从性,SSRS,疼痛水平是影响踝关节手术后分阶段功能训练后功能表现的独立危险因素。踝关节手术后的临床护理应包括镇痛和健康教育措施,以确保肢体功能的最佳恢复。
BACKGROUND: The recovery of limb function after ankle fracture surgery is a gradual process. The main purpose of implementing early functional exercise, joint mobility, muscle contraction function, passive ankle flexion and extension exercises, or physical factor therapy techniques is to achieve the rapid recovery of normal physiological limb function. However, currently the most effective rehabilitation training method is staged limb functional exercise, which promotes rapid recovery of limb function while preventing adverse consequences caused by overwork or insufficient training. Staged limb functional exercise divides the rehabilitation process into multiple stages, each of which has specific training objectives and contents. This method helps patients gradually restore limb function. Nevertheless, some patients still exhibit poor limb function after standardized exercise. Therefore, a functional evaluation should be performed to analyze the impact of staged functional training after ankle fracture surgery.
OBJECTIVE: To perform a functional evaluation and determine the influencing factors of staged functional training in patients with ankle fracture.
METHODS: A retrospective study enrolled 150 patients who underwent surgical treatment for ankle fracture from May 2020 to May 2022 at our hospital. Univariate and multivariate linear regression analyses were performed on general data, functional exercise compliance scale for orthopedic patients, Social Support Rating Scale (SSRS), American Orthopedic Foot and Ankle Score (AOFAS) Ankle-Hindfoot Score, and pain factors [serum bradykinin (BK), prostaglandin E2 (PGE2), 5-hydroxytryptamine (5-HT)].
RESULTS: Based on the AOFAS Ankle-Hindfoot Scale, the cases were divided into the excellent function (n = 111) and ordinary function (n = 39) groups. Univariate analysis revealed that monthly family income, education level, diabetes mellitus, functional exercise compliance scale of orthopedic patients score, SSRS, BK, PGE2, and 5-HT significantly influenced limb function after ankle fracture (P < 0.05); Multiple linear regression analysis showed that the functional exercise compliance scale score, SSRS, BK, PGE2, and 5-HT were independent risk factors affecting functional performance after staged functional exercise (P < 0.05).
CONCLUSIONS: Exercise compliance, SSRS, and pain level are the independent risk factors affecting functional performance after staged functional training following ankle surgery. Clinical nursing care after ankle surgery should include analgesic and health education measures to ensure optimal recovery of limb function.