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護理暨健康照護研究 Scopus

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篇名 連續被動性運動對於膝關節置換術後老年病人之影響—以台灣某醫學中心骨科病房為例
卷期 8:2
並列篇名 Continuous Passive Motion: Effect on Post-Total Knee Arthroplasty Elders at an Orthopedic Ward in Central Taiwan
作者 鄭秀容杜異珍巫美惠潘建州陳昆輝李政鴻
頁次 158-166
關鍵字 連續被動性運動主動性膝關節彎曲角度住院日數膝關節置換術老年病人continuous passive motionactive knee flexionlength of staytotal knee arthroplastyolder patients
出刊日期 201206

中文摘要

背 景: 主動性膝關節彎曲角度為膝關節置換術之主要成果指標。臨床上醫師對連續被動性運動之不同主張常造成護理人員的困擾,而相關研究療程與效果亦各有差異,故引發探討動機。目 的: 瞭解術後連續被動性運動對於膝關節置換術後老年病人主動性膝關節彎曲角度及住院日數之影響。方 法: 將某醫學中心2009年4月至12月共77位接受膝關節置換術之老年病人隨機分派為實驗組與對照組,並排除風濕性關節炎、手術部位已接受過相同手術者。實驗組(n = 40)接受加速性復健治療及每天3次、每次30分鐘的連續被動性運動,對照組(n = 37)僅採用加速性復健治療。主動性膝關節彎曲角度測量之一致性達99.17%。結 果: 實驗組與對照組在術後第2天到第6天之主動性膝關節彎曲角度及住院日數皆未出現顯著差異。結論/實務應用:不建議將連續被動性運動列為已接受加速性復健治療之膝關節置換術後老年病人的常規治療。

英文摘要

Background: Active knee flexion is a major outcome indicator of total knee arthroplasty (TKA). TKA patients typicallyreceive accelerated rehabilitation and continuous passive motion (CPM) therapies after surgery. Althoughorthopedic surgeons at the author’s hospital accept the efficacy of accelerated rehabilitation, they hold mixedopinions about the efficacy of CPM. Also, studies of CPM in the literature have used diverse study designs andachieved mixed results. This lack of consensus confuses nurses about if and when to apply this therapy.Purpose: This study compared the efficacy of two post-TKA rehabilitation programs for elder patients. One includedCPM and one did not. Active knee flexion and length of stay were study outcomes.Methods: We recruited 77 elder subjects who underwent TKA for osteoarthritis at a medical center in central Taiwanbetween April and December in 2009. Subjects were randomly assigned to experimental (n=40) and control (n=37)groups. Patients with rheumatic arthritis or who had previously undergone the same surgery at the same site wereexcluded. The experimental group received accelerated physical therapy and 30 minutes of CPM therapy threetimes a day. The control group received only accelerated physical therapy. Two nurses measured subject activeknee flexion with a consistency of 99.17%.Results: We found no significant difference in active knee flexion between the two groups from the second to thesixth day after surgery. There was also no significant difference in subject length of stay.Conclusion / Implications for practice: The results of this study do not support the use of CPM as a routine complementarytherapy to accelerated physical therapy in post-TKA rehabilitation programs.

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