[Effects of mobile health intervention on early knee function after anterior cruciate ligament reconstruction: a prospective randomized controlled study]

Zhonghua Wai Ke Za Zhi. 2020 Dec 1;58(12):936-941. doi: 10.3760/cma.j.cn112139-20200723-00575.
[Article in Chinese]

Abstract

Objective: To investigate the early clinical effects of home-based mobile health intervention on knee joint function after anterior cruciate ligament (ACL) reconstruction. Methods: This was a prospective randomized controlled trial. Patients undergoing arthroscopic ACL reconstruction alone at the Institute of Sports Medicine, Peking University Third Hospital from April 2019 to December 2019 were elected in the trial. Patients were divided into the intervention group and the control group according to random number method. The control group only received the guidance of the traditional paper rehabilitation schedule, while the intervention group also received personalized guidance of electronic rehabilitation prescription and follow-up notice delivered by a WeChat Mini Program Rehabilitation Cloud Platform in addition to the traditional guidance. Joint range of motion (ROM), visual analogue scale (VAS) and thigh circumference difference were assessed before and after the operation. Independent sample t test or Mann-Whitney U test was used for comparison of data between groups, and chi-square test was used for comparison of enumeration data. Results: One hundred and twenty five patients were enrolled in the trial, including 99 males and 26 females, with an average age of 29.0 years (range:18 to 45 years) and an average body mass index of 24.8 kg/m(2) (range:15.8 to 36.6 kg/m(2)). At 6 weeks, follow-up was available in 106 cases the target-reach rate of ROM in control group was 42.6%(23/54), which was 67.3%(35/52) in the intervention group, the difference was statistically significant (χ(2)=6.53, P=0.01); VAS of the intervention group was 2.5(2.0), lower than that of the control group 3.0(2.0)(M(Q(R))), the difference was statistically significant (Z=-2.06,P=0.04); And the thigh circumference difference of the intervention group was 2.0(2.0)cm lower than that of the control group 3.0(1.8)cm, the difference was statistically significant (Z=-3.00, P<0.01). Conclusion: Mobile health intervention can improve the early postoperative rehabilitation effect after ACL construction and the ROM of the knee joint, and reduce the bent-knee pain along with the thigh circumference difference.

目的: 探究移动健康干预对前交叉韧带重建术后居家康复患者早期膝关节功能的影响。 方法: 本研究为前瞻性病例对照研究。筛选2019年4月至2019年12月于北京大学第三医院运动医学研究所行关节镜下单纯前交叉韧带重建手术的患者纳入研究。按照随机数法将患者分为试验组与对照组,对照组术后仅接受传统的纸质康复计划表指导,试验组除传统康复指导外还接受"康复云平台"应用程序的康复处方推送与访视提醒的个性化指导。记录患者手术前后膝关节活动度、疼痛视觉模拟评分(VAS)及大腿周径差。组间计量资料的比较采用独立样本t检验或Mann-Whitney U检验,计数资料的比较采用χ(2)检验。 结果: 研究共纳入125例患者,男性99例,女性26例,平均年龄29.0岁(范围:18~45岁),体重指数24.8 kg/m(2)(范围:15.8~36.6 kg/m(2))。术后6周时共106例患者得到随访,其中对照组患者膝关节活动度达标率为42.6%(23/54),干预组为67.3%(35/52),差异有统计学意义(χ(2)=6.53,P=0.01);干预组VAS[MQ(R))]为2.5(2.0)分,低于对照组的3.0(2.0)分,差异有统计学意义(Z=-2.06,P=0.04);干预组大腿周径差为2.0(2.0)cm,低于对照组的3.0(1.8)cm,差异有统计学意义(Z=-3.00,P=0.003)。 结论: 移动健康干预能够改善前交叉韧带术后早期的康复效果,改善患者膝关节活动度,降低患者屈膝痛与大腿周径差。.

Keywords: Anterior cruciate ligament; Joint range of motion; Mobile health intervention; Reconstruction; Recovery of function.

MeSH terms

  • Adolescent
  • Adult
  • Anterior Cruciate Ligament Injuries* / rehabilitation
  • Anterior Cruciate Ligament Injuries* / surgery
  • Anterior Cruciate Ligament Reconstruction* / rehabilitation
  • Female
  • Humans
  • Knee Joint / surgery
  • Male
  • Middle Aged
  • Prospective Studies
  • Recovery of Function
  • Telemedicine*
  • Treatment Outcome
  • Young Adult