视频教育对全膝关节置换术后恐动症的影响△

Effect of video- assisted discharge education on kinesiophobia after total knee arthroplasty

摘要:

[目的] 评估视频辅助出院教育 （video-assisted discharge education, VADE） 方案对全膝关节置换术 （total knee ar- throplasty, TKA） 后恐动症的干预效果。[方法] 选取 2022 年 10 月—2023 年 5 月在本院拟进行 TKA 的 120 例患者，采用随机数字表法分为两组，60 例采用视频辅助出院教育方案 （视频组），60 例采用常规出院教育方案 （常规组），比较两组临床资料。[结果] 随着时间推移，两组患者 VAS 评分和 Tampa 评分均显著下降 （P＜0.05），而 ROM 和 HSS 评分均显著增加 （P＜ 0.05）。术前和术后 24 h 两组间 VAS 评分、ROM、HSS 评分、Tampa 评分的差异均无统计学意义（P＞0.05）；但是术后 1 个月，视频组在 VAS 评分 [(0.9±0.9) vs (1.4±0.6), P＜0.05]、ROM [(119.5±7.0)° vs (115.5±7.5)°, P＜0.05]、HSS 评分 [(85.7±3.3) vs (84.4±3.3), P＜ 0.05] 和 Tampa 评分 [(31.8±3.5) vs (33.3±3.2), P＜0.05] 均显著优于常规组。[结论]视频辅助出院教育方案可以有效降低 TKA 术后恐动症程度，缓解康复期疼痛，改善膝关节功能和膝伸屈活动度，提升患者术后满意度。

Abstract:

[Objective] To evaluate the outcomes of the video-assisted discharge education (VADE) program for intervention of kinesio- phobia after total knee arthroplasty (TKA). [Methods] One hundred and twenty patients who were undergoing TKA in our hospital from Octo- ber 2022 to May 2023 were included into this study, and divided into two groups using the random number table method, including 60 pa- tients in the video-assisted discharge education program (the video group) and 60 patients in the conventional discharge education program (the conventional group). The clinical data of the two groups were compared. [Results] All patients in both groups received corresponding dis- charge educations completely without statistically significant differences in age, sex, disease duration, and BMI between the two groups (P＞ 0.05). The VAS and Tampa scale for kinesiophobia significantly decreased (P＜0.05), while the knee extension- flexion range of motion (ROM) and HSS score significantly increased in both groups over time (P＜0.05). Th video group proved significantly superior to the conven- tional group in terms of VAS score [(0.9±0.9) vs (1.4±0.6), P＜0.05], ROM [(119.5±7.0)° vs (115.5±7.5)°, P＜0.05], HSS score [(85.7±3.3) vs (84.4±3.3), P＜0.05], and Tampa score [(31.8±3.5) vs (33.3±3.2), P＜0.05] one month postoperatively, despite of insignificant differences in abovementioned items before operation and 24 hours postoperatively between the two groups (P＞0.05). [Conclusion] The video-assisted dis- charge education program does effectively reduce the degree of postoperative TKA kinesiophobia, relieve pain during the rehabilitation peri- od, improve knee function and knee extension-flexion mobility, and enhance patients' postoperative satisfaction.