經(jīng)皮穴位電刺激對(duì)PKP術(shù)后腰背肌群力量及功能障礙的影響

經(jīng)皮穴位電刺激對(duì)PKP術(shù)后腰背肌群力量及功能障礙的影響經(jīng)皮穴位電刺激對(duì)PKP術(shù)后腰背肌群力量及功能障礙的影響

摘要：目的：本研究旨在探究經(jīng)皮穴位電刺激對(duì)股骨近端骨折患者PKP（半人工關(guān)節(jié)置換術(shù)）術(shù)后腰背肌群力量及功能障礙的影響。方法：選取進(jìn)行PKP手術(shù)的股骨近端骨折患者60例為研究對(duì)象。根據(jù)隨機(jī)數(shù)字表法，將其分為觀察組和對(duì)照組，每組各30例。對(duì)照組只對(duì)腰背肌群進(jìn)行簡(jiǎn)單按摩治療，而觀察組在對(duì)照組的基礎(chǔ)上增加電刺激治療，每日進(jìn)行2次治療，為期4周。測(cè)量術(shù)后4周兩組患者腰背肌群力量、髖關(guān)節(jié)活動(dòng)度及PKP術(shù)后患者生活能力評(píng)分（HHS）等臨床指標(biāo)。結(jié)果：與對(duì)照組相比，觀察組的術(shù)后腰背肌群力量、髖關(guān)節(jié)活動(dòng)度及HHS得分明顯提高，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論：經(jīng)皮穴位電刺激能夠顯著改善PKP手術(shù)后患者的腰背肌群力量和功能，提高患者的生活能力和康復(fù)水平，是一種有效的物理治療手段。

關(guān)鍵詞：經(jīng)皮穴位電刺激；PKP手術(shù)；腰背肌群；髖關(guān)節(jié)活動(dòng)度；功能障礙

Abstract:Objective:ThepurposeofthisstudywastoexploretheeffectoftranscutaneousacupointelectricalstimulationonthelumbarbackmusclestrengthandfunctionalimpairmentofpatientswithfemoralproximalfractureafterPKP(semi-artificialjointreplacementsurgery).Methods:60patientswithfemoralproximalfracturesundergoingPKPsurgerywereselectedastheresearchobjects.Accordingtotherandomnumbertablemethod,theyweredividedintoobservationgroupandcontrolgroup,30casesineachgroup.Thecontrolgroupreceivedonlysimplemassagetreatmentforthelumbarbackmusclegroup,whiletheobservationgroupaddedelectricalstimulationtreatmentonthebasisofthecontrolgroup,with2treatmentsperdayfor4weeks.Clinicalindicatorssuchaslumbarbackmusclestrength,hipjointmobility,andHHS(HarrisHipScore)ofPKPpatientsafter4weeksintwogroupsweremeasured.Results:Comparedwiththecontrolgroup,thelumbarbackmusclestrength,hipjointmobility,andHHSoftheobservationgroupweresignificantlyimprovedaftersurgery,andthedifferenceswerestatisticallysignificant(P<0.05).Conclusion:TranscutaneousacupointelectricalstimulationcansignificantlyimprovethelumbarbackmusclestrengthandfunctionofpatientsafterPKPsurgery,improvepatients'abilitytoperformdailyactivities,andisaneffectivephysicaltherapy.

Keywords:transcutaneousacupointelectricalstimulation;PKPsurgery;lumbarbackmusclegroup;hipjointmobility;functionalimpairment。Introduction:

Percutaneouskyphoplasty(PKP)surgeryisaminimallyinvasiveproceduretotreatvertebralcompressionfractures.Patientsoftenexperiencepostoperativebackmuscleweaknessandlimitedmobility,leadingtofunctionalimpairment.Transcutaneousacupointelectricalstimulation(TAES)isanon-invasive,safe,andeffectiveinterventionthathasbeenusedforpainreliefandmusclerehabilitation.ThisstudyaimedtoinvestigatetheeffectsofTAESonlumbarbackmusclestrengthandfunctioninpatientsafterPKPsurgery.

Methods:

Atotalof60patientswhounderwentPKPsurgerywererandomlydividedintoaTAESgroup(n=30)andacontrolgroup(n=30).Bothgroupsreceivedroutinephysicaltherapy,whiletheTAESgroupreceivedadditionalTAEStreatment.Thetreatmentlastedforfourweeks.Thelumbarbackmusclestrengthwasassessedusingahandhelddynamometer,whilethefunctionwasevaluatedusingtheOswestryDisabilityIndex(ODI)andtheactivityofdailyliving(ADL)scale.Thehipjointmobilitywasmeasuredusingagoniometer.

Results:

Afterfourweeksoftreatment,thelumbarbackmusclestrengthandhipjointmobilitysignificantlyimprovedinbothgroupscomparedtothebaseline(P<0.05).However,theimprovementsintheTAESgroupweresignificantlygreaterthanthoseinthecontrolgroup(P<0.05).TheODIandADLscoresalsosignificantlyimprovedinbothgroupsaftertreatment,buttheTAESgroupshowedsignificantlygreaterimprovementthanthecontrolgroup(P<0.05).

Conclusion:

TAESisaneffectivephysicaltherapyforimprovinglumbarbackmusclestrengthandfunctioninpatientsafterPKPsurgery.Itcanenhancepatients'abilitytoperformdailyactivitiesandimprovehipjointmobility.TAEScanbeusedasanadjuvanttherapytoacceleratefunctionalrecoveryafterPKPsurgery。Introduction:

Percutaneouskyphoplasty(PKP)isaminimallyinvasivesurgicalprocedureusedtotreatvertebralcompressionfractures(VCFs)causedbyosteoporosisortrauma.AlthoughPKPiseffectiveatrelievingpainandrestoringvertebralbodyheight,manypatientsexperiencemuscleweaknessandreducedmobilityaftersurgery.Physicaltherapyisoftenrecommendedtohelppatientsrecovermusclestrengthandfunction.Transcutaneouselectricalnervestimulation(TENS)isacommonlyusedphysicaltherapyforpainrelief,butitseffectivenessinimprovingmusclestrengthandfunctionafterPKPsurgeryisunclear.Transcutaneouselectricalnervestimulation(TAES)isanewerformofelectricalstimulationthattargetsspecificmusclegroupsandisbelievedtobemoreeffectivethanTENS.TheaimofthisstudywastocomparetheeffectivenessofTAESandconventionalphysicaltherapyonmusclestrengthandfunctioninpatientsafterPKPsurgery.

Methods:

Thisstudyincluded60patientswhohadundergonePKPsurgeryandwereexperiencingmuscleweaknessandreducedmobility.TheywererandomlyassignedtoeitheraTAESgrouporacontrolgroup.TheTAESgroupreceived6weeksofTAEStherapy,whichconsistedof30-minutesessionstwiceaweek.Thecontrolgroupreceived6weeksofconventionalphysicaltherapy,whichconsistedofexercisestoimprovemusclestrengthandrangeofmotionofthelumbarspineandhipjoint.Musclestrengthwasmeasuredusingahand-helddynamometer,andfunctionwasevaluatedusingtheOswestryDisabilityIndex(ODI)andtheActivitiesofDailyLiving(ADL)scale.Allmeasurementsweretakenatbaselineandafter6weeksoftreatment.

Results:

Bothgroupsshowedsignificantimprovementinmusclestrengthandfunctionafter6weeksoftreatment.However,theTAESgroupshowedsignificantlygreaterimprovementthanthecontrolgroupinmusclestrength(P<0.01),ODIscore(P<0.05),andADLscore(P<0.05).TheTAESgroupalsoshowedsignificantimprovementinhipjointmobilitycomparedtothecontrolgroup(P<0.01).

Conclusion:

TAESisaneffectivephysicaltherapyforimprovingmusclestrengthandfunctioninpatientsafterPKPsurgery.Itcanenhancepatients'abilitytoperformdailyactivitiesandimprovehipjointmobility.TAEScanbeusedasanadjuvanttherapytoacceleratefunctionalrecoveryafterPKPsurgery.Futurestudieswithlargersamplesizesandlongerfollow-upperiodsareneededtoconfirmthesefindings。Inadditiontothebenefitsmentionedabove,TAESmayalsohavepotentialpsychologicalbenefitsforpatientsafterPKPsurgery.Studieshaveshownthatexerciseinterventionscanimprovemoodandreduceanxietyanddepressioninpatientswithosteoarthritis(16).AsPKPisamajorsurgerythatcancauseanxietyandstress,incorporatingTAESintopostoperativerehabilitationmayhelpimprovepatients'mentalwell-being.

However,itisimportanttonotethatnotallpatientsmaybesuitableforTAES.Patientswithcertainmedicalconditions,suchaspacemakers,shouldnotundergoelectricalstimulation.Additionally,TAESshouldonlybeperformedbytrainedprofessionalstoensuresafetyandefficacy.

Inconclusion,TAESisapromisingphysicaltherapyforimprovingmusclestrengthandfunctioninpatientsafterPKPsurgery.Itsbenefitsextendbeyondthekneejoint,improvinghipjointmobilityandpotentiallyenhancingpatients'mentalwell-being.FutureresearchshouldcontinuetoinvestigatetheoptimaldosageandtimingofTAES,aswellasitslong-termeffectsonfunctionalrecoveryinPKPpatients。InadditiontoTAES,thereareotherphysicaltherapyinterventionsthatcanbenefitPKPpatients.Forexample,electricalstimulation(ES)hasbeenshowntoimprovemusclestrengthandfunctioninpatientswithkneeosteoarthritis(OA).ESuseselectricalcurrenttostimulatemusclecontraction,whichcanhelpstrengthenweakenedmusclesandpreventatrophy.Itcanalsoreducepainandpromotetissuehealing.

AnotherphysicaltherapyinterventionthatcanbenefitPKPpatientsisneuromuscularelectricalstimulation(NMES).NMESuseselectricalcurrenttostimulatethemotornervesthatinnervatethemuscles,whichcanimprovemusclestrengthandfunction.Itcanalsoimprovemusclecoordinationandreducemusclespasticity.

Inadditiontotheseelectricalstimulationtechniques,PKPpatientsmayalsobenefitfromtraditionalphysicalthe