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題名:前十字韌帶重建術後穿戴膝護具之必要性探討--系統性回顧與統合分析     (28點)
Systematic Review&Meta-Analysis:Is Brace Necessary after Anterior Cruciate Ligament Reconstruction?
著者:邱馨儀(Shine-Yi Chiou) ;高宜暄(Yi-Hsuan Kao) ;郭曉縈(Hsiao-Ying Kuo) ;陳佳琳(Chia-Ling Chen) ;施怡芬(Yi-Fen Shih) ;李雪楨(Hsuei-Chen Lee) ;陳文英(Wen-Yin Chen)
出版地區:台灣
出版城市:台北市
學科:物理 ; 醫學綜合
關鍵字:前十字韌帶重建 ; 膝護具 ; 統合分析 ; ACL reconstruction ; Brace ; Meta-analysis
刊名:物理治療
卷期:35卷1期(2010.3)
頁碼:24-37
語言:繁體中文
摘要: 中文摘要PDF ; 英文摘要PDF

背景與目的:在前十字韌帶重建手術後,醫師常會建議患者配戴膝護具以提供膝關節的支持保 護,然而最近的研究指出穿戴膝護具也許不會有較佳的復原效果。本研究的目的為探討前十字韌 帶重建手術後穿戴膝護具的必要性。研究方法:搜尋資料庫中現有的文獻比較有無穿戴膝護具對 前十字韌帶重建術後復健療效的隨機控制研究或臨床控制研究進行系統性回顧及統合分析。療效 評估項目包括關節活動角度、膝關節鬆強度、等速運動力短峰值、功能活動表現及術後併發症。 結果與討論:最終選取6 篇研究,受試者共310 人。部分研究資料統合分析結果顯示在膝屈曲活動 角度(整體效益值: 0 .3 94) 與膝屈曲等速慢速運動力矩峰值(整體效益值: 0 .440 、0 , 338 )在術後六 個月末穿戴膝護具較有穿戴膝護具者佳。而膝關節鬆抽度、單腳跳測試及術後併發症在兩組則未 達統計上顯著差異。系統性回顧顯示Lysholm 功能評分及Tegner 活動等級在術後六個月末穿戴膝護 具者較有穿戴膝護具者佳,但在術後一年至五年期間,兩組則未達統計上顯著差異。結論:前十 字韌帶重建于術後穿戴膝護具相較於未穿戴者並不會有較佳的療效。而未穿戴膝護具者在術後六 個月內有較佳的膝屈曲活動角度與肌力。因此,前十字韌帶重建術後患者就身體活動表現的考量 是不需要穿戴膝護具的。(物理治療2010;35(1):24-37 )
Background and Purpose: Bracing for support and protection after anterior cruciate ligament (ACL) reconstruction has been a common practice, and most of the clinicians would recommend wearing the brace after the surgery to their patients a decade ago. Recent studies, however, found that wearing the brace might not provide additional benefits for better recovery. The purpose of this study is to investigate whether wearing the brace is necessary after ACL reconstruction. Methods: We searched literature and selected articles with randomized or clinical controlled trials that compared wearing the brace with no-brace in the rehabilitation program after ACL reconstruction for this review. Outcome measures included range of motion (ROM), knee laxity, isokinetic peak torque, one-leg hop, Lysholm functional score, Tegner activity level, and complications during the short and long term follow-up periods. Results: Six studies were included and the total number of subjects was 310. Meta-analysis revealed the improvements of knee flexion ROM (effect size, d=0.394) was significantly better in the no-brace group during the first 6 months after surgery. And peak isokinetic flexion torque of slow speed (d= 0.440, 0.338) were also significantly better in the no-brace group during the 6 months and first year after surgery. Knee laxity, one-leg hop performance, and complications were not different between the two groups in the short and long term follow-ups. Moreover, our review showed that the Lysholm functional score and the Tegner activity level were better in the no-brace group during the short term follow-ups but the difference was not significant after 12 months. Conclusions: Wearing the brace after ACL reconstruction did not guaranty better improvements. On the contrary, patients without wearing a brace during their rehabilitation demonstrated better improvements in ROM and muscle strength during the first 6 months after the surgery. (FJPT 201O;35( 1 ):24-37)


    

本卷期目次
物理治療 35卷1期 (2010.3)
台灣老人身體活動能力與日常生活功能之階層相關探討/ 葉婷婷王靜怡林志峰陳惠雅
嚴重阻塞性睡眠呼吸中止症患者其呼吸道發炎反應與肺功能之探討/ 林珮君李佩玲吳惠東莊雅惠王儷穎
前十字韌帶重建術後穿戴膝護具之必要性探討--系統性回顧與統合分析/ 邱馨儀高宜暄郭曉縈陳佳琳施怡芬李雪楨陳文英
運動訓練對周邊動脈疾病患者周邊循環之療效:系統回顧與統合分析/ 趙婉茹吳英黛劉千綺
發展性舞蹈運動訓練對於發展障礙兒童的動作精練程度之影響:可行性報告/ 劉文瑜陳怡蓁彭曼筠黃維彬林燕慧連恒裕
中華民國物理治療學會第六十次學術研討會--論文摘要/ 陽明大學
原發性肺動脈高壓患者運動能力與生活品質相關因素之探討/ 蕭淑芳吳英黛徐紹勛賴玉玫
 
   
 
   

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