基于强化理论的智能远程康复模式在前交叉韧带重建术患者院外康复中的应用 [中文引用][英文引用]

目的  探讨基于强化理论的智能远程康复模式对前交叉韧带重建术（anterior cruciate ligament reconstruction，ACLR）患者院外康复效果的影响。方法  采用便利抽样法，选取 2022 年 6 月— 2023 年 6 月在武汉市某三级甲等综合医院行前交叉韧带重建术的 120 例患者作为研究对象，其中 2022 年 6 月— 12 月 60 例为对照组，2023 年 1 月— 6 月 60 例为试验组。对照组出院后按照术后常规进行康复指导，试验组在对照组的基础上，实施基于强化理论的智能远程康复模式，比较两组患者的康复训练依从性和膝关节功能。结果  试验组患者术后居家康复训练依从性高于对照组，两组比较，差异具有统计学意义（P<0.05）。试验组患者术后 1 年与术前膝关节主观评分表（the International Knee Documentation Committee subjective knee form，IKDC）评分、Lysholm 评分差值高于对照组，两组比较，差异具有统计学意义（均 P<0.05），试验组疼痛、肿胀、膝关节不稳、交锁等异常情况少于对照组，两组比较，差异具有统计学意义（均 P<0.05）。试验组患者 1 年后日常生活的程度和重返运动的情况优于对照组，两组比较，差异有统计学意义（P<0.05）。结论  实施基于强化理论的智能远程康复模式可提高患者康复依从性，促进膝关节功能的恢复，降低前交叉韧带重建患者术后疼痛、肿胀、膝关节不稳、交锁等异常体征的发生率，从而恢复生活和运动。

Objective To investigate the effect of an intelligent telerehabilitation developed with reinforcement theory on the postoperative functional recovery and return to sport in patients after reconstructive surgery of anterior cruciate ligament. Methods By using the convenience sampling method, 120 patients after reconstructive surgery of anterior cruciate ligament at a tertiary general hospital in Wuhan from June 2022 to June 2023 were selected as the research subjects. Sixty patients admitted to our hospital between June 2022 and December 2022 were assigned to a control group, while another 60 patients admitted to our hospital between January 2023 and June 2023 were assigned to an trial group. The patients in the control group received conventional surgical treatment, nursing care and instructions for rehabilitation, whereas additional rehabilitation based on the intelligent telerehabilitation developed with reinforcement theory was given to the patients in the trial group. The two groups were compared in terms of postoperative knee function and compliance with rehabilitation exercise. Results The compliance of the trial group with home rehabilitation training was higher than that of the control group. The comparison between the two groups showed a statistically significant difference（P<0.05）. 12 months after surgery, patients in the trial group exhibited higher scores in International Knee Documentation Committee Subjective knee form（IKDC）and Lysholm and Gillquist knee scores compared with those in the control group（both P<0.05. Also, the patients in trial group showed lower incidences of pain, swelling and joint instability compared with those in the control group（all P<0.05）. At 12 months after surgery, the patients in trial group showed better capability to perform daily activities and participate in sports in comparison with those in the control group（both P<0.05）. Conclusion The intelligent telerehabilitation based on reinforcement theory can improve the compliance of patient with rehabilitation. It therefore is able to reduce incidences of postoperative complications such as pain, swelling, knee instability and locking in patients who had the surgery for reconstruction of anterior cruciate ligament. It also enhances the function recovery of knee, and helps patients to resume the activities in life and sports