| Objective: To observe the efficacy and feasibility of comprehensive traditional Chinese medicine rehabilitation therapy combined with exercise therapy(CTCMR-ET)in the treatment of knee stiffness after tibial plateau fracture(TPF).Meanwhile,we try to standardize the treatment of comprehensive traditional Chinese medicine rehabilitation therapy(CTCMRT)and exercise therapy(ET).In order to further explore how to better combine the two therapies and clinical promotion to provide some useful help.Methods: In September 2015 to January 2017 in Sichuan Province Department of rehabilitation hospital department of orthopedics outpatient and inpatient department for tibial plateau fracture postoperative knee stiffness in treatment of patients with a total of 52 cases.The patients were randomly divided into experimental group and control group with 26 cases in each group.Experimental group were treated with CTCMR-ET,the CTCMRT including acupuncture,Re-Yanbao,traditional joint adhesions combined with joint mobilization and cryotherapy,ET including joint mobilization training,muscle strength training.With the exception of joint mobilization for once-daily,three times a week,other treatments for once-daily,five times a week for a course of treatment,with two days off per course of treatment,lasts for 4 courses(4 weeks).The control group was treated with CTCMRT.And the specific operation and treatment items and the course of treatment were not different from those in the experimental group.The observation time and effect index included the scores of the treatment scale.At the end of the experiment,the data were analyzed and processed by our researchers with SPSS22.0 software.Results: 1.After 4 weeks of treatment,the total effective rate of CTCMR-ET(experimental group)and CTCMRT(control group)for the treatment of post-operative tibial plateau fracture of knee joint stiffness was 88.46% and 65.38%,respectively(P<0.05).It showed that the effect of the treatment group was better than that of the control group.2.The effective observation indexes(including knee flexion,extension limitation,range of motion,VAS scores,muscle strength,ADL scores and HSS scores)post-treatment in the two groups of patients reduce significantly(P<0.05)compared with those prior-treatment.The results showed that these therapeutics(CTCMR-ET or CTCMRT)could improve the two groups of patients’ clinical symptoms at different degrees.3.With the exception of VAS scores between the two groups(P>0.05),There were significant differences in three indexes(knee joint flexion,extension limitation,range of motion,muscle strength,ADL scores,HSS scores)between experimental group and control group(P<0.05).And the indexes of experimental group of patients were better than the control group.It showed that CTCMR-ET had better effect on improving the knee joint flexion,extension limitation,range of motion、muscle strength,ADL scores,HSS scores than the CTCMRT,but no significance on VAS scores.Conclusion: 1.Both CTCMR-ET and CTCMRT could improve clinical symptoms that included the range of motion,pain degrees,activities of daily living,and the knee function of the patients with knee stiffness after post-operative tibial plateau fracture.Patients treated by CTCMR-ET could improve the knee joint flexion,extension limitation,range of motion,muscle strength,ADL scores,HSS scores better than CTCMRT.But in the improvement of painful knee joint,the effect of the two treatments were similar;2.According to the clinical efficacy of comprehensive evaluation,the treatment of CTCMR-ET which had significant effect on treating knee stiffness after post-operative tibial plateau fracture were better than CTCMRT;3.CTCMR-ET is an effective protocol for the treatment of knee joint stiffness after post-operative tibial plateau fracture.It has good curative effect,short course,reliable,maneuverability,and clinical promotion value. |
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