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

Continuous Passive Motion: Effect on Post-Total KneeArthroplasty Elders at an Orthopedic Ward in Central Taiwan

10.6225/JNHR.08.2.158

鄭秀容(Hsiu-Jung Cheng)；杜異珍(Yih-Jen Duh)；巫美惠(Mei-Hui Wu)；潘建州(Chien-Chou Pan)；陳昆輝(Kun-Hui Chen)；李政鴻(Cheng-Hung Lee)

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 motion ； active knee flexion ； length of stay ； total knee arthroplasty ； older patients

護理暨健康照護研究

8卷2期（2012 / 06 / 01）

158 - 166

繁體中文

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。

Background: Active knee flexion is a major outcome indicator of total knee arthroplasty (TKA). TKA patients typically receive accelerated rehabilitation and continuous passive motion (CPM) therapies after surgery. Although orthopedic surgeons at the author's hospital accept the efficacy of accelerated rehabilitation, they hold mixed opinions about the efficacy of CPM. Also, studies of CPM in the literature have used diverse study designs and achieved 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 included CPM 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 Taiwan between 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 were excluded. The experimental group received accelerated physical therapy and 30 minutes of CPM therapy three times a day. The control group received only accelerated physical therapy. Two nurses measured subject active knee 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 the sixth 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 complementary therapy to accelerated physical therapy in post-TKA rehabilitation programs.