膝关节置换术后病人家庭康复治疗有效性的Meta分析

摘要

Objective:To systematically review the effectiveness of home rehabilitation exercise for the physical function,pain,degree of joint flexion in patients after total knee replacement.Methods:Randomized controlled trials (RCT) literature and clinical control studies about the effectiveness of home rehabilitation exercise following total knee replacement were retrieved from The Cochrane Library,JBI Library,MEDLINE,Embase,Pubmed,CNKI,VIP,and WanFang Database.Two independent researchers retrieved literatures,screened literatures,assessed included literatures quality,and extracted the data according to inclusion criteria and exclusion criteria.The RevMan 5.3 software was used to perform meta-analysis.Results:Totally 7 published studies were included,all of them were RCTs.The results of meta-analysis showed that compared with the control (routine rehabilitation) group,in the experiment (family rehabilitation) group joint buckling degree was improved significantly within three months [Z=3.91,P＜ 0.000 1,MD =-4.13,95 ％ CI (-6.21,-2.05)],but only a short-term significance and no long-term effect.Neither physical function nor pain relief improved significantly.Conclusions:In the short term,home rehabilitation exercise could significantly improve the joint flexion of patients after knee replacement.%[目的]系统评价家庭康复治疗对膝关节置换术后病人生理功能、疼痛、关节活动度有效性的研究.[方法]计算机检索Cochrane图书馆、JBI循证护理中心图书馆、MEDLINE、Embase、PubMed、中国知网数据库(CNKI)、维普数据库(VIP)、万方数据库,收集所有膝关节置换术后家庭康复治疗的随机对照试验和临床对照研究,由2名研究者按照纳入和排除标准独立检索文献、筛选文献、评价纳入文献的质量,并提取资料,使用RevMan 5.3软件进行Meta分析.[结果]共纳入7篇文献,均为随机对照试验.Meta分析结果显示:试验组(家庭康复治疗)与对照组(常规康复治疗)相比,家庭康复治疗3个月内关节屈曲度得到显著改善[Z=3.91,P＜0.000 1,MD=-4.13,95％CI(-6.21,-2.05)],但只是一个短期的意义,没有长远的效果;生理功能和疼痛缓解都没有显著改善.[结论]家庭康复治疗的干预措施能在短期内显著改善膝关节置换术后病人的关节活动度.