智能可穿戴设备BPMpathway在全膝关节置换术后患者居家康复中的应用效果

doi:10.3969/j.issn.1674-8115.2024.03.006

上海交通大学学报（医学版） ›› 2024, Vol. 44 ›› Issue (3): 342-349.doi: 10.3969/j.issn.1674-8115.2024.03.006

• 论著 · 临床研究 • 上一篇

智能可穿戴设备BPMpathway在全膝关节置换术后患者居家康复中的应用效果

洪洋¹(), 王洁¹(), 张霞芬², 赵丹¹, 程敏³

^1.苏州大学附属第四医院（苏州市独墅湖医院）护理部，苏州 215125
^2.苏州大学附属第四医院（苏州市独墅湖医院）骨科，苏州 215125
^3.苏州大学附属第一医院骨科，苏州 215006

收稿日期:2023-08-13 接受日期:2023-01-08 出版日期:2024-03-28 发布日期:2024-04-29
通讯作者: 王洁 E-mail:281130052@qq.com;2418866391@qq.com
作者简介:洪洋（1990—），女，主管护师，硕士；电子信箱：281130052@qq.com。
基金资助:
苏州市科技发展计划项目(SZM2021021)

Efficacy of smart wearable device BPMpathway in home rehabilitation of patients after total knee arthroplasty

HONG Yang¹(), WANG Jie¹(), ZHANG Xiafen², ZHAO Dan¹, CHENG Min³

^1.Nursing Department, The Fourth Affiliated Hospital of Soochow University (Suzhou Dushu Lake Hospital), Suzhou 215125, China
^2.Orthopedics Department, The Fourth Affiliated Hospital of Soochow University (Suzhou Dushu Lake Hospital), Suzhou 215125, China
^3.Department of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou 215006, China

Received:2023-08-13 Accepted:2023-01-08 Online:2024-03-28 Published:2024-04-29
Contact: WANG Jie E-mail:281130052@qq.com;2418866391@qq.com
Supported by:
Suzhou Science and Technology Plan Project(SZM2021021)

摘要/Abstract

摘要：

目的·评价基于智能可穿戴设备BPMpathway的居家康复方案在全膝关节置换（total knee arthroplasty，TKA）术后患者中的应用效果。方法·采用方便抽样法，选取苏州大学附属第四医院（苏州市独墅湖医院）和苏州大学附属第一医院骨科2021年4月—2022年12月收治的膝关节骨关节炎并接受TKA术的患者作为研究对象。按照患者入院顺序，将住院号尾数为奇数的患者纳入对照组，住院号尾数为偶数的患者纳入干预组。对照组患者给予常规居家康复训练方案，干预组在对照组的基础上实施基于BPMpathway的远程居家康复训练方案。分别于基线及术后1、3、6个月采用骨科患者功能锻炼依从性量表、美国特种外科医院膝关节评分表（Hospital for Special Surgery Scale，HSS）和36项简明健康状况调查表（36-item Short Form Health Survey，SF-36）对2组患者进行测评，同时测量患者的膝关节活动度。结果·最终纳入110例患者，其中对照组56例，干预组54例。2组患者的一般资料差异无统计学意义。2组患者基线时的膝关节活动度、HSS评分、SF-36评分差异均无统计学意义。重复测量方差分析结果显示：2组患者膝关节活动度、功能锻炼依从性评分、HSS评分及SF-36评分的组间效应、时间效应及交互效应均具有统计学意义（均P<0.05）。术后1、3、6个月干预组的膝关节活动度、功能锻炼依从性评分、HSS评分及SF-36评分均高于对照组（均P<0.05）。结论·医护人员基于智能可穿戴设备BPMpathway开展的远程康复训练方案，有助于提高TKA术后患者居家康复期间功能锻炼的依从性，改善膝关节活动度，促使膝关节功能恢复，提高其生存质量，对患者预后具有积极的作用。

关键词: 膝关节置换术, 骨关节炎, 可穿戴设备, BPMpathway, 远程康复

Abstract:

Objective ·To evaluate the effectiveness of the tele-rehabilitation program based on the smart wearable device BPMpathway in patients after total knee arthroplasty (TKA). Methods ·Convenience sampling method was used to select patients with knee osteoarthritis after TKA admitted to both the Department of Orthopedics in the Fourth Affiliated Hospital of Soochow University (Suzhou Dushu Lake Hospital) and The First Affiliated Hospital of Soochow University, from April 2021 to December 2022, as the study population. According to the sequence of the patients′ admissions, patients with an odd hospitalization number were allocated to the control group while those with an even number to the intervention group. The control group received the routine home-based rehabilitation training program, while the intervention group was additionally subjected to the tele-rehabilitation program based on the BPMpathway. At baseline, and 1 month, 3 months and 6 months after TKA, the two groups of patients were evaluated by the compliance scale of functional exercise for orthopedic patients, the Hospital for Special Surgery Scale (HSS), and 36-item Short Form Health Survey (SF-36), while the knee joint motion of the patients was measured. Results ·One hundred and ten patients with knee osteoarthritis after TKA were finally enrolled, including 56 patients in the control group and 54 patients in the intervention group. There were no statistically significant differences in the general information between the two groups. The differences in knee range of motion, HSS score, and SF-36 score between the two groups at baseline were not statistically significant. Repeated measurement variance analysis showed that the between-group effect, time effect and interaction effect of knee range of motion, functional exercise compliance score, HSS score and SF-36 total score were statistically significant in both groups (all P<0.05). Meanwhile, knee range of motion, HSS score, functional exercise compliance score, and SF-36 score in the intervention group were significantly better than those in the control group at 1, 3, and 6 months after TKA (all P<0.05). Conclusion ·The tele-rehabilitation training program, conducted by healthcare providers using the smart wearable device BPMpathway, can enhance patients′ compliance with functional exercise during home rehabilitation after TKA. This leads to increased knee mobility, contributes to the recovery of knee function and improves quality of life of the patients. All of these factors have a positive effect on the patient prognosis.

Key words: total knee arthroplasty (TKA), osteoarthritis, BPMpathway, wearable device, tele-rehabilitation

中图分类号:

R473.6

洪洋, 王洁, 张霞芬, 赵丹, 程敏. 智能可穿戴设备BPMpathway在全膝关节置换术后患者居家康复中的应用效果[J]. 上海交通大学学报（医学版）, 2024, 44(3): 342-349.

HONG Yang, WANG Jie, ZHANG Xiafen, ZHAO Dan, CHENG Min. Efficacy of smart wearable device BPMpathway in home rehabilitation of patients after total knee arthroplasty[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2024, 44(3): 342-349.

图/表 3

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Characteristic variable	Intervention group (n=54)	Control group (n=56)	t/χ² value	P value
Gender/n(%)			0.292	0.589
Male	18 (33.33)	16 (28.57)
Female	36 (66.67)	40 (71.43)
Age/year	68.67±7.13	68.18±5.32	-0.408	0.684
Education/n(%)			0.678	0.712
Junior high and below	31 (57.41)	34 (60.71)
Senior high school/technical secondary school	17 (31.48)	14 (25.00)
Junior college and above	6 (11.11)	8 (14.29)
Work/n(%)			0.111	0.739
In service	17 (31.48)	16 (28.57)
Not in service	37 (68.52)	40 (71.43)
Marital status/n(%)			0.041	0.840
Married	47 (87.04)	48 (85.71)
Single and others	7 (12.96)	8 (14.29)
Chronic comorbidities/n(%)			0.151	0.698
Yes	29 (53.70)	28 (50.00)
No	25 (46.30)	28 (50.00)

Characteristic variable	Intervention group (n=54)	Control group (n=56)	t/χ² value	P value
Gender/n(%)			0.292	0.589
Male	18 (33.33)	16 (28.57)
Female	36 (66.67)	40 (71.43)
Age/year	68.67±7.13	68.18±5.32	-0.408	0.684
Education/n(%)			0.678	0.712
Junior high and below	31 (57.41)	34 (60.71)
Senior high school/technical secondary school	17 (31.48)	14 (25.00)
Junior college and above	6 (11.11)	8 (14.29)
Work/n(%)			0.111	0.739
In service	17 (31.48)	16 (28.57)
Not in service	37 (68.52)	40 (71.43)
Marital status/n(%)			0.041	0.840
Married	47 (87.04)	48 (85.71)
Single and others	7 (12.96)	8 (14.29)
Chronic comorbidities/n(%)			0.151	0.698
Yes	29 (53.70)	28 (50.00)
No	25 (46.30)	28 (50.00)

Time	Knee range of motion^①				HSS score^②				Function exercise compliance score^③
Time	Intervention group (n=54)	Control group (n=56)	t value	P value	Intervention group (n=54)	Control group (n=56)	t value	P value	Intervention group (n=54)	Control group (n=56)	t value	P value
Baseline	80.52±4.12	80.89±3.72	-0.493	0.623	55.81±10.00	54.63±9.31	0.646	0.519	‒	‒	‒	‒
Post-operation
1 month	103.51±4.94	98.03±4.84	5.876	0.000	70.37±5.34	63.52±8.10	5.220	0.000	62.57±9.46	56.48±8.53	3.549	0.001
3 months	113.86±4.95	106.42±5.08	7.779	0.000	83.02±6.50	73.41±7.16	7.361	0.000	58.06±7.89	51.18±6.27	5.071	0.000
6 months	124.10±3.91	115.76±5.19	9.494	0.000	92.46±5.77	84.32±5.36	7.667	0.000	54.26±6.66	45.88±5.56	7.180	0.000

Time	Knee range of motion^①				HSS score^②				Function exercise compliance score^③
Time	Intervention group (n=54)	Control group (n=56)	t value	P value	Intervention group (n=54)	Control group (n=56)	t value	P value	Intervention group (n=54)	Control group (n=56)	t value	P value
Baseline	80.52±4.12	80.89±3.72	-0.493	0.623	55.81±10.00	54.63±9.31	0.646	0.519	‒	‒	‒	‒
Post-operation
1 month	103.51±4.94	98.03±4.84	5.876	0.000	70.37±5.34	63.52±8.10	5.220	0.000	62.57±9.46	56.48±8.53	3.549	0.001
3 months	113.86±4.95	106.42±5.08	7.779	0.000	83.02±6.50	73.41±7.16	7.361	0.000	58.06±7.89	51.18±6.27	5.071	0.000
6 months	124.10±3.91	115.76±5.19	9.494	0.000	92.46±5.77	84.32±5.36	7.667	0.000	54.26±6.66	45.88±5.56	7.180	0.000

Time	Score of physical component summary^①				Score of mental component summary^②				SF-36 total score^③
Time	Intervention group (n=54)	Control group (n=56)	t value	P value	Intervention group (n=54)	Control group (n=56)	t value	P value	Intervention group (n=54)	Control group (n=56)	t value	P value
Baseline	44.29±10.37	45.12±11.41	-0.400	0.690	56.40±15.24	54.15±12.89	0.836	0.405	54.08±8.81	52.84±7.18	0.816	0.416
Post-operation
1 month	59.35±10.58	54.34±11.01	2.429	0.017	70.07±9.54	66.39±8.82	2.104	0.038	66.57±7.46	62.59±6.05	3.083	0.003
3 months	83.41±7.07	70.73±11.11	7.112	0.000	87.17±4.77	69.92±5.52	17.507	0.000	86.23±4.66	70.28±6.12	15.340	0.000
6 months	94.91±5.02	84.57±10.68	6.459	0.000	92.46±5.77	84.32±5.36	12.994	0.000	93.90±5.39	80.96±5.63	12.302	0.000

智能可穿戴设备BPMpathway在全膝关节置换术后患者居家康复中的应用效果

Efficacy of smart wearable device BPMpathway in home rehabilitation of patients after total knee arthroplasty

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