Author: |
賴力綱 Lai, Li-Kang |
---|---|
Thesis Title: |
全人工膝關節置換術前功能性肌力訓練之初探 The preliminary study of preoperative functional-based muscle strengthening outcomes before total knee arthroplasty |
Advisor: |
張家豪
Chang, Jia-Hao |
Committee: |
蔡鏞申
Tsai, Yung-Shen 林惠婷 Lin, Hui-Ting 張家豪 Chang, Jia-Hao |
Approval Date: | 2022/09/17 |
Degree: |
碩士 Master |
Department: |
體育與運動科學系運動科學碩士在職專班 Continuing Education Master's Program of Sports Science |
Thesis Publication Year: | 2022 |
Academic Year: | 110 |
Language: | 中文 |
Number of pages: | 54 |
Keywords (in Chinese): | 復健 、術前復健 、關節炎 、負重背心 、運動醫學 |
Keywords (in English): | rehabilitation, prehabilitation, osteoarthritis, weighted vest, sport medicine |
DOI URL: | http://doi.org/10.6345/NTNU202201747 |
Thesis Type: | Academic thesis/ dissertation |
Reference times: | Clicks: 173 Downloads: 15 |
Share: |
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目的:探討退化性膝關節炎第四級患者,於全人工膝關節置換術前進行功能性肌力訓練,是否影響術前及術後關節炎症狀與功能性動作表現。方法:從臺灣中部某醫院骨科門診招募12位受試者,將其平均分配至單次訓練組、雙次訓練組及控制組。單次訓練組於手術前一週額外進行一次運動介入,雙次訓練組於手術前二週額外進行每週一次運動介入,運動介入前後使用腳踏機進行暖身及收操,並於主訓練過程採用穿戴式負重背心執行三項功能性運動訓練,分別為平地直線行走、上下樓梯及椅子坐站訓練,三組皆會執行常規衛教、術後床邊運動及助行器行走訓練。分別於安排手術之當次門診進行前測(T0)、手術前一天入院第一次後測(T1)、手術後第6週第二次後測(T2)、手術後第12週第三次後測(T3)收集數據,包括WOMAC膝關節功能量表、膝伸肌力、椅子坐站測試、功能性伸手測試、四方格跨步測試、起身繞圓測試、40公尺快步行走測試、樓梯攀登測試與Y字平衡測試,並使用敘述性統計描述各組內及組間差異。結果:單次訓練組相較控制組更有助於在T1有功能性動作表現及自覺感受立即性增長,而後維持表現至T3,但控制組於T0至T3之功能性動作表現也呈現漸進式進步至相似水平。結論:對於退化性膝關節炎第四級患者,進行全人工膝關節置換術前功能性肌力訓練介入,於術前一週額外使用負重背心進行單次功能性動作訓練,相較控制組更有助於提早在術前有功能性動作表現及自覺感受立即性增長,但控制組於術後十二週亦以產生足夠學習效應改善膝關節退化者術後功能性動作表現。
Purpose: This study is aimed to investigate whether preoperative functional-based muscle strengthening in patients with grade 4 knee osteoarthritis affects the arthritis symptoms and functional-based performance. Method: Twelve participants were recruited from the orthopedic clinic of a hospital in central Taiwan, and they were equally divided into three groups which are single-training group, double-training group, and control group. Single-training group trained for one time a week before the operation while double-training group trained for two cycles before the operation. A pedal machine was used to warm up and cool down during experiments. Also, participants wore a weight-bearing vest to perform three functional-based exercises, which were respectively walking, stair climbing, and sit-to-stand. The baseline data came from the day when participants recruited from the clinic, the day before the operation(T1), six weeks after the operation(T2) and twelve weeks after the operation(T3). Data from different times included WOMAC, knee extensor strength, chair-standing test, functional-reaching test, four-squared steps test, time-up-and-go, forty meters fast-paced walking test, stair-climbing test and Y-balance test. Data was analyzed through descriptive statistics to explore the difference among each group. Result: Compared with control group, single-training group was more conducive to the immediate increase of functional-based movement performance and symptoms improvement at T1 and maintained until T3. The functional-based movement performance of the control group also showed a gradual progression from T0 progress to a similar level at T3. Conclusion: For patients with grade 4 knee osteoarthritis, preoperative functional-based muscle strengthened once had immediately improved the knee joint symptoms and physical function before the surgery. On the other hand, control group also had gradual improvement from baseline to twelve weeks after the surgery. This learning effect was adequate to improve the functional-based movement performance for those who had knee osteoarthritis.
國家發展委員會(2022,8月)。中華民國人口推估(2022年至2070年)。作者。
American College of Sports Medicine. (2021). ACSM’s guidelines for exercise testing and prescription (11th ed.). Wolters Kluwer.
Alghadir, A. H., Anwer, S., Sarkar, B., Paul, A. K., & Anwar, D. (2019). Effect of 6-week retro or forward walking program on pain, functional disability, quadriceps muscle strength, and performance in individuals with knee osteoarthritis: a randomized controlled trial (retro-walking trial). BMC Musculoskeletal Disorders, 20(1). https://doi.org/10.1186/s12891-019-2537-9
Baggen, R. J., van Roie, E., Verschueren, S. M., van Driessche, S., Coudyzer, W., van Dieën, J. H., & Delecluse, C. (2019). Bench stepping with incremental heights improves muscle volume, strength and functional performance in older women. Experimental Gerontology, 120, 6–14. https://doi.org/10.1016/j.exger.2019.02.013
Bennell, K., Dobson, F., & Hinman, R. (2011). Measures of physical performance assessments: Self-Paced Walk Test (SPWT), Stair Climb Test (SCT), Six-Minute Walk Test (6MWT), Chair Stand Test (CST), Timed Up & Go (TUG), Sock Test, Lift and Carry Test (LCT), and Car Task. Arthritis Care & Research, 63(S11), S350–S370. https://doi.org/10.1002/acr.20538
Casaña, J., Calatayud, J., Ezzatvar, Y., Vinstrup, J., Benítez, J., & Andersen, L. L. (2019). Preoperative high-intensity strength training improves postural control after TKA: randomized-controlled trial. Knee Surgery, Sports Traumatology, Arthroscopy, 27(4), 1057–1066. https://doi.org/10.1007/s00167-018-5246-2
Christensen, J. C., Mizner, R. L., Foreman, K. B., Marcus, R. L., Pelt, C. E., & LaStayo, P. C. (2018). Quadriceps weakness preferentially predicts detrimental gait compensations among common impairments after total knee arthroplasty. Journal of Orthopaedic Research®, 36(9), 2355–2363. https://doi.org/10.1002/jor.23894
Cui, A., Li, H., Wang, D., Zhong, J., Chen, Y., & Lu, H. (2020). Global, regional prevalence, incidence and risk factors of knee osteoarthritis in population-based studies. EClinicalMedicine, 29–30, 100587. https://doi.org/10.1016/j.eclinm.2020.100587
Department of Health and Social Care. (2019). UK Chief Medical Officers' physical activity guidelines. Author.
di Laura Frattura, G., Zaffagnini, S., Filardo, G., Romandini, I., Fusco, A., & Candrian, C. (2019). Total knee arthroplasty in patients with knee osteoarthritis: effects on proprioception. A systematic review and best evidence synthesis. The Journal of Arthroplasty, 34(11), 2815–2822. https://doi.org/10.1016/j.arth.2019.06.005
Dobbs, M. B., Buckwalter, J., & Saltzman, C. (1999). Osteoporosis: the increasing role of the orthopaedist. The Iowa orthopaedic journal, 19, 43–52. https://pubmed.ncbi.nlm.nih.gov/10847516/
Dobson, F., Hinman, R., Roos, E., Abbott, J., Stratford, P., Davis, A., Buchbinder, R., Snyder-Mackler, L., Henrotin, Y., Thumboo, J., Hansen, P., & Bennell, K. (2013). OARSI recommended performance-based tests to assess physical function in people diagnosed with hip or knee osteoarthritis. Osteoarthritis and Cartilage, 21(8), 1042–1052. https://doi.org/10.1016/j.joca.2013.05.002
Domínguez-Navarro, F., Igual-Camacho, C., Silvestre-Muñoz, A., Roig-Casasús, S., & Blasco, J. M. (2018). Effects of balance and proprioceptive training on total hip and knee replacement rehabilitation: A systematic review and meta-analysis. Gait & Posture, 62, 68–74. https://doi.org/10.1016/j.gaitpost.2018.03.003
Flandry, F., & Hommel, G. (2011). Normal Anatomy and Biomechanics of the Knee. Sports Medicine and Arthroscopy Review, 19(2), 82–92. https://doi.org/10.1097/jsa.0b013e318210c0aa
Gomiero, A. B., Kayo, A., Abraão, M., Peccin, M. S., Grande, A. J., & Trevisani, V. F. (2018). Sensory-motor training versus resistance training among patients with knee osteoarthritis: randomized single-blind controlled trial. Sao Paulo Medical Journal, 136(1), 44–50. https://doi.org/10.1590/1516-3180.2017.0174100917
Greendale, G. A., Salem, G. J., Young, J. T., Damesyn, M., Marion, M., Wang, M. Y., & Reuben, D. B. (2000). A Randomized Trial of Weighted Vest Use in Ambulatory Older Adults: Strength, Performance, and Quality of Life Outcomes. Journal of the American Geriatrics Society, 48(3), 305–311. https://doi.org/10.1111/j.1532-5415.2000.tb02651.x
Guadagnin, E. C., Priario, L. A., Carpes, F. P., & Vaz, M. A. (2019, September). Correlation between lower limb isometric strength and muscle structure with normal and challenged gait performance in older adults. Gait &Amp; Posture, 73, 101–107. https://doi.org/10.1016/j.gaitpost.2019.07.131
Hinman, R. S., Hunt, M. A., Creaby, M. W., Wrigley, T. V., McManus, F. J., & Bennell, K. L. (2010). Hip muscle weakness in individuals with medial knee osteoarthritis. Arthritis Care & Research, 62(8), 1190–1193. https://doi.org/10.1002/acr.20199
Husby, V. S., Foss, O. A., Husby, O. S., & Winther, S. B. (2018). Randomized controlled trial of maximal strength training vs. standard rehabilitation following total knee arthroplasty. European Journal of Physical and Rehabilitation Medicine, 54(3). https://doi.org/10.23736/s1973-9087.17.04712-8
Jahic, D., Omerovic, D., Tanovic, A., Dzankovic, F., & Campara, M. (2018). The effect of prehabilitation on postoperative outcome in patients following primary total knee arthroplasty. Medical Archives, 72(6), 439. https://doi.org/10.5455/medarh.2018.72.439-443
Jessup, J. V., Horne, C., Vishen, R. K., & Wheeler, D. (2003). Effects of exercise on bone density, balance, and self-efficacy in older women. Biological Research For Nursing, 4(3), 171–180. https://doi.org/10.1177/1099800402239628
Kanamoto, T., Mae, T., Yokoyama, T., Tanaka, H., Ebina, K., & Nakata, K. (2020). Significance and definition of early knee osteoarthritis. Annals of Joint, 5, 4. https://doi.org/10.21037/aoj.2019.09.02
Karpiński, R., Jaworski, U., Jonak, J., & Krakowski, P. (2019). Stress distribution in the knee joint in relation to tibiofemoral angle using the finite element method. MATEC Web of Conferences, 252, 07007. https://doi.org/10.1051/matecconf/201925207007
Kean, W. F., Kean, R., & Buchanan, W. W. (2004). Osteoarthritis: symptoms, signs and source of pain. InflammoPharmacology, 12(1), 3–31. https://doi.org/10.1163/156856004773121347
Levinger, P., Menz, H. B., Morrow, A. D., Wee, E., Feller, J. A., Bartlett, J. R., & Bergman, N. (2012). Lower limb proprioception deficits persist following knee replacement surgery despite improvements in knee extension strength. Knee Surgery, Sports Traumatology, Arthroscopy, 20(6), 1097–1103. https://doi.org/10.1007/s00167-011-1710-y
Mair, J. L., de Vito, G., & Boreham, C. A. (2019). Low volume, home-based weighted step exercise training can improve lower limb muscle power and functional ability in community-dwelling older women. Journal of Clinical Medicine, 8(1), 41. https://doi.org/10.3390/jcm8010041
Messier, S. P., Mihalko, S. L., Beavers, D. P., Nicklas, B. J., DeVita, P., Carr, J. J., Hunter, D. J., Lyles, M., Guermazi, A., Bennell, K. L., & Loeser, R. F. (2021). Effect of high-intensity strength training on knee pain and knee joint compressive forces among adults with knee ssteoarthritis. JAMA, 325(7), 646. https://doi.org/10.1001/jama.2021.0411
Messier, S. P., Mihalko, S. L., Legault, C., Miller, G. D., Nicklas, B. J., DeVita, P., Beavers, D. P., Hunter, D. J., Lyles, M. F., Eckstein, F., Williamson, J. D., Carr, J. J., Guermazi, A., & Loeser, R. F. (2013). Effects of intensive diet and exercise on knee joint loads, inflammation, and clinical outcomes among overweight and obese adults with knee osteoarthritis. JAMA, 310(12), 1263. https://doi.org/10.1001/jama.2013.277669
Mierzwicki, J. T. (2019). Weighted vest training in community-dwelling older adults: A randomized, controlled pilot study. Physical Activity and Health, 3(1), 108–116. https://doi.org/10.5334/paah.43
Miller, R. M., Beavers, D. P., Cawthon, P. M., Crotts, C., Fanning, J., Gerosa, J., Greene, K. A., Hsieh, K. L., Kiel, J., Lawrence, E., Lenchik, L., Lynch, S. D., Nesbit, B. A., Nicklas, B. J., Weaver, A. A., & Beavers, K. M. (2021). Incorporating nutrition, vests, education, and strength training (INVEST) in bone health: Trial design and methods. Contemporary Clinical Trials, 104, 106326. https://doi.org/10.1016/j.cct.2021.106326
Nejati, P., Farzinmehr, A., & Moradi-Lakeh, M. (2015). The effect of exercise therapy on knee osteoarthritis: a randomized clinical trial. Medical journal of the Islamic Republic of Iran, 29, 186. https://pubmed.ncbi.nlm.nih.gov/26034739/
Normandin, E., Yow, D., Crotts, C., Kiel, J., Beavers, K., & Nicklas, B. (2018). Feasibility of weighted vest use during a dietary weight loss intervention and effects on body composition and physical function in older adults. The Journal of Frailty & Aging, 1–6. https://doi.org/10.14283/jfa.2018.17
Øiestad, B. E., Juhl, C. B., Culvenor, A. G., Berg, B., & Thorlund, J. B. (2021). Knee extensor muscle weakness is a risk factor for the development of knee osteoarthritis: an updated systematic review and meta-analysis including 46 819 men and women. British Journal of Sports Medicine, 56(6), 349–355. https://doi.org/10.1136/bjsports-2021-104861
Pedersen, M. M., Petersen, J., Bean, J. F., Damkjaer, L., Juul-Larsen, H. G., Andersen, O., Beyer, N., & Bandholm, T. (2015). Feasibility of progressive sit-to-stand training among older hospitalized patients. PeerJ, 3, e1500. https://doi.org/10.7717/peerj.1500
Peng, X., Liu, G., & Guo, Z. (2010). Finite element contact analysis of a human sagittal knee joint. Journal of Mechanics in Medicine and Biology, 10(02), 225–236. https://doi.org/10.1142/s0219519410003423
Pozzi, F., Snyder-Mackler, L., & Zeni, J. (2013). Physical exercise after knee arthroplasty: a systematic review of controlled trials. European journal of physical and rehabilitation medicine, 49(6), 877–892. https://pubmed.ncbi.nlm.nih.gov/24172642/
Puthoff, M. L., Darter, B. J., Nielsen, D. H., & Yack, H. J. (2006). The effect of weighted vest walking on metabolic responses and ground reaction forces. Medicine & Science in Sports & Exercise, 38(4), 746–752. https://doi.org/10.1249/01.mss.0000210198.79705.19
Salem, G. J., Flanagan, S. P., Wang, M. Y., Song, J. E., Azen, S. P., & Greendale, G. A. (2004). Lower-extremity kinetic response to weighted-vest resistance during stepping exercise in older Adults. Journal of Applied Biomechanics, 20(3), 260–274. https://doi.org/10.1123/jab.20.3.260
Sano, Y., Iwata, A., Wanaka, H., Matsui, M., Yamamoto, S., Koyanagi, J., & Iwata, H. (2018). An easy and safe training method for trunk function improves mobility in total knee arthroplasty patients: A quasi-randomized controlled trial. PLOS ONE, 13(10), e0204884. https://doi.org/10.1371/journal.pone.0204884
Schache, M. B., McClelland, J. A., & Webster, K. E. (2016). Does the addition of hip strengthening exercises improve outcomes following total knee arthroplasty? A study protocol for a randomized trial. BMC Musculoskeletal Disorders, 17(1). https://doi.org/10.1186/s12891-016-1104-x
Schache, M. B., McClelland, J. A., & Webster, K. E. (2019). Incorporating hip abductor strengthening exercises into a rehabilitation program did not improve outcomes in people following total knee arthroplasty: a randomised trial. Journal of Physiotherapy, 65(3), 136–143. https://doi.org/10.1016/j.jphys.2019.05.008
Sharma, L., Chmiel, J. S., Almagor, O., Felson, D., Guermazi, A., Roemer, F., Lewis, C. E., Segal, N., Torner, J., Cooke, T. D. V., Hietpas, J., Lynch, J., & Nevitt, M. (2013). The role of varus and valgus alignment in the initial development of knee cartilage damage by MRI: the MOST study. Annals of the Rheumatic Diseases, 72(2), 235–240. https://doi.org/10.1136/annrheumdis-2011-201070
Sharma, R., Ardebili, M. A., & Abdulla, I. N. (2019). Does rehabilitation before total knee arthroplasty benefit postoperative recovery? A systematic review. Indian Journal of Orthopaedics, 53(1), 138–147. https://doi.org/10.4103/ortho.ijortho_643_17
Skoffer, B., Dalgas, U., Maribo, T., Søballe, K., & Mechlenburg, I. (2018). No exacerbation of knee joint pain and effusion following preoperative progressive resistance training in patients scheduled for total knee arthroplasty: Secondary analyses from a randomized controlled trial. PM&R, 10(7), 687–692. https://doi.org/10.1016/j.pmrj.2017.11.002
Skoffer, B., Maribo, T., Mechlenburg, I., Korsgaard, C. G., Søballe, K., & Dalgas, U. (2020). Efficacy of preoperative progressive resistance training in patients undergoing total knee arthroplasty: 12-month follow-up data from a randomized controlled trial. Clinical Rehabilitation, 34(1), 82–90. https://doi.org/10.1177/0269215519883420
Stevens, J. E., Mizner, R. L., & Snyder-Mackler, L. (2003). Quadriceps strength and volitional activation before and after total knee arthroplasty for osteoarthritis. Journal of Orthopaedic Research, 21(5), 775–779. https://doi.org/10.1016/s0736-0266(03)00052-4
Swärd, P., Fridén, T., Boegård, T., Kostogiannis, I., Neuman, P., & Roos, H. (2013). Association between varus alignment and post-traumatic osteoarthritis after anterior cruciate ligament injury. Knee Surgery, Sports Traumatology, Arthroscopy, 21(9), 2040–2047. https://doi.org/10.1007/s00167-013-2550-8
Tomljanović, M., Spasić, M., Gabrilo, G., Uljević, O. i Foretić, N. (2011). Effects of five weeks of functional vs. traditional resistance training on anthropometric and motor performance variables. Kinesiology, 43. (2.), 145-154. Preuzeto s https://hrcak.srce.hr/75434
United States Department of Health and Human Services. (2018). Physical Activity Guidelines for Americans (2nd ed.). Author.
van Leeuwen, D. M., de Ruiter, C. J., Nolte, P. A., & de Haan, A. (2014). Preoperative strength training for elderly patients awaiting total knee arthroplasty. Rehabilitation Research and Practice, 2014, 1–9. https://doi.org/10.1155/2014/462750
Volpi, E., Nazemi, R., & Fujita, S. (2004). Muscle tissue changes with aging. Current Opinion in Clinical Nutrition and Metabolic Care, 7(4), 405–410. https://doi.org/10.1097/01.mco.0000134362.76653.b2
World Health Organization. (2020). WHO guidelines on physical activity and sedentary behaviour. Author.