膝骨性关节炎康复课件

膝骨性关节节炎 (Knee Osteoarthiritis) 上海交通大学附属第六人民医院 预防保健 手术方法 康复治疗 临床评价 膝骨性关节炎 病理改变 研究背景 定义 诊断标准 研 究 背 景 Joint pain, specifically chronic knee pain (CKP), is a frequent cause of Chronic pain and limitation of function and mobility among older adults. Multiple evidence-based guidelines recommend exercise as a first-line treatment for all patients with CKP or knee osteoarthritis (KOA), yet healthcare practitioners attitudes and beliefs may limit their implementation. This systematic review aims to identify the attitudes, beliefs and behaviours of General Practitioners (GPs) regarding the use of exercise for CKP/KOA. BMC Family Practice 2010, 11:4 doi:10.1186/1471-2296-11-4 研 究 背 景 The increasing age of the population, especially in the western world, means that the prevalence of osteoarthritis is also increasing, with corresponding socioeconomic consequences. Although there is no curative intervention at present, in accordance with US and European guidelines, pharmacotherapeutic and non-pharmacological approaches aim at pain control and the reduction of functional restriction. BMC Musculoskeletal Disorders 2009, 10:104 (19 August 2009) 研 究 背 景 The disabling symptoms of osteoarthritis of the knee can be dramatically improved with joint replacement. The aim of this study was to examine the change in pain and physical function that occurs in patients with osteoarthritic knees awaiting total knee replacement. Eur J Orthop surg Traumatol (2005) 15:309-312 研 究 背 景 Osteoarthritis of the knee is a degenerative disease that causes joint pain, stiffness, and decreased function. Treatment is multidisciplinary and involves physical therapy, medication, and surgery. Arthroscopic surgery, in which an arthroscopy is inserted into the knee joint, allows for larvae, a procedure that removes particulate material such as cartilage fragments and calcium crystals. It also allows for debridement, whereby articular surfaces and osteophytes can be surgically smoothed. The goal of this procedure is to reduce synovitis and eliminate mechanical interference with joint motion. N Engl J Med 2009;361(20):2004 定 义 危害老年人身心健康的主要疾病 发生在滑膜关节的一种缓慢的、以局部关节软骨破坏 并伴有相邻软骨下骨板骨质增生/骨唇形成的骨关节病 伴有不同程度的滑膜炎症反应 诊断标准（1995 ACR) 膝骨关节炎存在:具备(1),(2), (3),(4) 或(1),(2), (5) 或(1),(2), (4),(5) 膝骨关节炎存在:具备(1),(2) 或(1),(3), (5) 或(1),(4), (5),(6) 病 理 改 变 手术方法 手术方法 康 复 治 疗 康 复 治 疗 康 复 治 疗 临床评价 临床评价 临 床 基 础 评 价 FEBS Journal Vol. 276, 24, Pages: 7375-7385 临 床 基 础 评 价 FEBS Journal Vol. 276, 24, Pages: 7375-7385 临 床 基 础 评 价 FEBS Journal Vol. 276, 24, Pages: 7375-7385 步 态 参 数 Kinematics parameters 运动学参数 1.ONE1.ONE Kinetics parameters 动力学参数 2 2. .TWOTWO Surface EMG 表面肌电 3 3. .THREETHREE Energy conservation parameters 能量参数 4 4. .FOURFOUR 运 动 学 参 数 运 动 学 参 数 骨盆偏斜 骨盆倾斜 骨盆旋转 运 动 学 参 数 髋内收-外展运动轨迹 髋屈-伸运动轨迹 髋旋转运动轨迹 运 动 学 参 数 膝屈-伸 膝内收-外展 膝内-外翻