神经肌肉电刺激联合卧位蹬车训练在膝关节交叉韧带损伤重建术后康复中的应用

Application of neuromuscular electrical stimulation combined with supine cycling training in rehabilitation after knee cruciate ligament reconstruction

摘要:

目的 探讨神经肌肉电刺激联合卧位蹬车训练在膝关节交叉韧带损伤重建术后康复中的应用效果。方法 选取2022年1月—2025年12月在徐州医科大学附属淮安医院行膝关节交叉韧带损伤重建术的86例患者作为研究对象，按随机数字表法将其分为对照组与观察组，各43例。对照组接受常规康复训练和神经肌肉电刺激，观察组在对照组基础上联合卧位蹬车训练，两组均持续干预至术后6个月。记录患者术后6个月的肌力水平，并比较干预前后的步态参数（步频、最大步速、单足支撑时间百分比、足底压力差）、膝关节活动度、功能锻炼依从性、膝关节功能、自我效能、生活质量。结果 观察组肌力水平的优良率高于对照组（P <0.05）。观察组干预后膝关节屈伸、内旋及外旋活动度均高于对照组（P <0.05）。同组内，干预后膝关节屈伸、内旋及外旋活动度均高于干预前（P <0.05）。观察组干预后步频、最大步速、单足支撑时间百分比均高于对照组，足底压力差低于对照组（P <0.05）。同组内，干预后步频、最大步速、单足支撑时间百分比均高于干预前，足底压力差低于干预前（P <0.05）。观察组干预后依从性、自我效能、Lysholm评分均高于对照组（P <0.05）。同组内，干预后依从性、自我效能、Lysholm评分均高于干预前（P <0.05）。观察组干预后生活质量各项评分均高于对照组（P <0.05）。同组内，干预后生活质量各项评分高于干预前（P <0.05）。结论 神经肌肉电刺激联合卧位蹬车训练用于膝关节交叉韧带损伤重建术后康复，可有效提高肌力，优化步态参数与膝关节功能，进而改善患者生活质量。

Abstract:

Objective To investigate the effect of neuromuscular electrical stimulation combined with supine cycling training in rehabilitation after knee cruciate ligament reconstruction.Methods A total of 86 patients with knee cruciate ligament injury who underwent reconstruction surgery and were admitted to the Department of Rehabilitation Medicine of the Affiliated Huai'an Hospital of Xuzhou Medical University from January 2022 to December 2025 were enrolled. They were divided into a control group and an observation group using a random number table method, with 43 cases in each group. The control group received conventional rehabilitation training and neuromuscular electrical stimulation, while the observation group received additional supine cycling training on the basis of the control group. Both groups were intervened for 6 months after surgery. Muscle strength at 6 months after surgery was evaluated, and gait parameters (step frequency, maximum walking speed, percentage of single-leg support time, plantar pressure difference), knee range of motion, functional exercise compliance, knee function (Lysholm score), self-efficacy, and quality of life were compared between the two groups before and after intervention.Results The excellent/good rate of muscle strength in the observation group was significantly higher than that in the control group (P < 0.05). The observation group also showed greater knee range of motion in flexion-extension, internal rotation, and external rotation compared to the control group (P < 0.05). Within the same group, post-intervention range of motion was significantly higher than pre-intervention values for all three directions (P < 0.05). The observation group demonstrated significantly higher step frequency, maximum walking speed, and percentage of single-leg support time, but a lower plantar pressure difference compared to the control group (P < 0.05). Within the same group, all gait parameters improved significantly after intervention (P < 0.05). The observation group scored higher than the control group in compliance, self-efficacy, and Lysholm scores (all P < 0.05). For both groups, post-intervention scores were higher than pre-intervention scores for these measures (all P < 0.05). Additionally, the observation group had higher quality-of-life scores than the control group (P < 0.05), and within the same group, post-intervention quality-of-life scores were higher than pre-intervention scores (P < 0.05).Conclusion Neuromuscular electrical stimulation combined with supine cycling training can effectively improve muscle strength, optimize gait parameters and knee function, and further enhance the quality of life in patients undergoing knee cruciate ligament reconstruction.