Application of situational simulation rehabilitation management based on patients'home demand in patients after total knee arthroplasty

LIU Lu; LUAN Xing-yi; TONG Shuai

doi:10.3969/j.issn.2095-252X.2024.04.003

Abstract：Objective To explore the effects of situational simulation rehabilitation management based on patients'home demand on lower limb motor function and quality of life in patients after total knee arthroplasty(TKA).Methods A total of 90 elderly patients after TKA were enrolled from March 2021 to September 2022,and all were randomly divided into control group(45 cases)and experimental group(45 cases)according to random number table method.The control group received routine rehabilitation training after operation.In the experimental group,the routine rehabilitation training was supplemented with situational simulation rehabilitation management based on patients'home needs.The hospital for special surgery(HSS score),6-minute walk test(6MWT),range of motion(ROM),visual analogue scale(VAS),Generic Quality of Life Inventory 74(GQOLI-74),and the incidence of postoperative complications such as prosthetic loosening,deep vein thrombosis,and infection were compared between the two groups of patients.Results HSS scores 2 months after surgery:control group 50.62±6.43,experimental group 56.42±6.87.6MWT 2 months after surgery:control group(342.45±12.98)m,experimental group(366.09±13.56)m.ROM 2 months after surgery:control group(91.22±6.01)°,experimental group(96.35±6.32)°.HSS scores 6 months after surgery:control group 76.87±6.11,experimental group 84.21±8.25.6MWT 6 months after surgery:control group(395.34±12.07)m,experimental group(429.65±14.14)m.ROM 6 months after surgery:control group(115.27±5.27)°,experimental group(119.31±5.84)°.HSS score,6MWT,and ROM of the experimental group were higher than those of the control group at 2 months and 6 months after surgery,and the differences were statistically significant(P<0.05).The VAS scores of the control group were 3.33±0.85,1.67±0.41,and 0.99±0.23 at 1 month,2 months,and 3 months after surgery,respectively,while the experimental group were 2.87±0.77,1.25±0.32,and 0.78±0.12,respectively.The results showed that at 1,2,and 3 months after surgery,the VAS of both groups decreased with time,and the VAS scores of the experimental group were lower than those of the control group,with statistically significant differences(P<0.05).Six months after surgery,the quality of life in the experimental group was higher than that in the control group,and the differences were statistically significant(P = 0.002).Six months after surgery,the incidence of postoperative complications such as prosthetic loosening,deep vein thrombosis,and infection in the experimental group was 8.89%,with no statistically significant difference compared to 15.56%in the control group(P>0.05).Conclusions The situational simulation rehabilitation treatment management based on patients'home demand can improve lower limb motor function of elderly patients after TKA,relieve postoperative pain and improve quality of life,which is worthy of clinical promotion.