多因素物理治疗与股骨头动态建模法在膝关节挫伤后撞击综合征中的应用（临床病例）



如何引用文章

全文:

开放存取 开放存取
受限制的访问 ##reader.subscriptionAccessGranted##
受限制的访问 订阅或者付费存取

详细

背景。因运动损伤而需进行膝关节韧带结构矫正的患者数量显著增加，使寻找非药物康复手段成为高度关注的方向。患者的临床特点（年轻，运动损伤病因未明且病程复杂）、俄罗斯社会在关注从事高强度体育训练的儿童与青少年健康方面的意识提升，以及提升全民健康水平与生活质量的国家目标，共同凸显出在职业发展框架内对康复专业人才培训和运动测试系统化研究进行系统分析的重要性。

目的。评估多因素物理治疗（超声导入与光照治疗）及在膝关节结构动态建模框架内进行的运动训练，对磁共振成像显示的股骨内侧髁骨髓水肿消退的影响及其合理性。

材料与方法。本研究报告一例（19岁）青年足球运动员的临床病例，其表现为股骨头无菌性坏死的风险、膝关节韧带结构改变及关节积液。在高强度竞技训练背景下，患者突发膝关节剧烈疼痛并无法负重。列出了个性化康复模式实施前后动态观察中的评估指标。

结果。联合采用四种干预手段（功能锻炼、超声导入软骨保护剂"Artra"、红光及红外非相干光照射），在未使用药物的情况下，于治疗第7天实现疼痛缓解（Visual Analog Scale评分）和骨髓水肿消退，并于3个月后完全恢复运动训练负荷。强调该多因素康复方案中自身体重牵引与后等长放松训练的阶段性与系统性特征。

结论。精选的个体化运动疗法与三种物理治疗手段的同步应用可形成一种高效的适应性康复方案，在急性期早期介入条件下显著提升治疗效果，并可降低股骨头无菌性坏死的发生风险。

全文:

受限制的访问

作者简介

Natalya G. Kulikova

I.M. Sechenov First Moscow State Medical University; Peoples' Friendship University of Russia

编辑信件的主要联系方式.
Email: Kulikovang777@mail.ru
ORCID iD: 0009-0007-0374-6763
SPIN 代码: 1827-7880

MD, Dr. Sci. (Medicine), Professor

俄罗斯联邦, Moscow; Moscow

Mustafa Kh. Al-Zamil

Peoples' Friendship University of Russia

Email: alzamil@mail.ru
ORCID iD: 0000-0002-3643-982X
SPIN 代码: 3434-9150

MD, Dr. Sci. (Medicine), Professor of the Department

俄罗斯联邦, Moscow

Numman Yu. Mansour

Peoples' Friendship University of Russia

Email: rocstar-fo@to.ru
ORCID iD: 0009-0002-9246-5640
SPIN 代码: 7571-0085

MD, Cand. Sci. (Medicine), Associate Professor

俄罗斯联邦, Moscow

Albina S. Тkаchenkо

Peoples' Friendship University of Russia

Email: rocstar-fo@to.ru
ORCID iD: 0000-0001-8506-8562
SPIN 代码: 6126-1475

MD, Cand. Sci. (Medicine), Associate Professor

俄罗斯联邦, Moscow

Pavel V. Naydenov

Rozanov Moscow Regional Hospital

Email: pnaidenov@mos.ru
ORCID iD: 0009-0006-4036-2526
SPIN 代码: 5184-8161
俄罗斯联邦, Pushkino

参考

  1. Hamstra-Wright KL, Bliven KCH, Napier C. Training load capacity, cumulative risk, and bone stress injuries: a narrative review of a holistic approach. Front Sports Act. Living. 2021;3:665683. doi: 10.3389/fspor.2021.665683
  2. Snoeker B, Turkiewicz A, Magnusson K, et al. Risk of knee osteoarthritis after different types of knee injuries in young adults: a population-based cohort study. Br J Sports Med. 2020;54(12):725–730. doi: 10.1136/bjsports-2019-100959
  3. Kaeding CC, Léger-St-Jean B, Magnussen RA. Epidemiology and diagnosis of anterior cruciate ligament injuries. Clin. Sports Med. 2017;36(1):1–8. doi: 10.1016/j.csm.2016.08.001
  4. Patricios JS, Schneider KJ, Dvorak J, et al. Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport — Amsterdam, October 2022. Br. J. Sports Med. 2023;57(11):695–711. doi: 10.1136/bjsports-2023-106898
  5. Ertogrul R, Varol A, Oc Y, Kilinc BE. Is peroneus longus allograft good alternative for anterior cruciate ligament reconstruction: a comparison study. Acta Chir Orthop Traumatol Cech. 2021;88(1):58–62.
  6. Ionescu AM, Pitsiladis YP, Rozenstoka S, et al. Preparticipation medical evaluationfor elite athletes: EFSMA recommendations on standardised preparticipation evaluation form in European countries. BMJ Open Sport Exerc Med. 2021;7(4):e001178. doi: 10.1136/bmjsem-2021-001178
  7. Leys T, Salmon L, Waller A, et al. Clinical results and risk factors for reinjury 15 years after anterior cruciate ligament reconstruction: a prospective study of hamstring and patellar tendon grafts. Am J Sports Med. 2012;40(3):595–605. doi: 10.1177/0363546511430375
  8. Ochi J, Nozaki T, Nimura A, et al. Subchondral insufficiency fracture of the knee: review of current concepts and radiological differential diagnoses. Jpn J Radiol. 2022;40(5):443–457. doi: 10.1007/s11604-021-01224-3
  9. Bortoletto R, Silva NS, Zângaro RA, et al. Mitochondrial membrane potential after low-power laser irradiation. Lasers Med Sci. 2004;18(4):204–206. doi: 10.1007/s10103-003-0281-7
  10. Gocevska M, Nikolikj-Dimitrova E, Gjerakaroska-Savevska C. Effects of high — intensity laser in treatment of patients with chronic low back pain. Open Access Maced J Med Sci. 2019;7(6):949–954. doi: 10.3889/oamjms.2019.117
  11. Kotenko KV, Epifanov VA, Epifanov AV, Korchazhkina NB. Joint pain. Moscow: GEOTAR-Media; 2018. 560 p. (In Russ.) EDN: ZRRKSR
  12. Korchazhkina NB, Mikhailova AA, Kovalyov SA, et al. Justification for the use of the method of deep oscillation of a pulsed low-frequency electrostatic field in the early rehabilitation period after surgery. Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2020;19(4):244–248. doi: 10.17816/1681-3456-2020-19-4-7. EDN: SPFFLL
  13. Lien-Iversen T, Morgan DB, Jensen C, et al. Does surgery reduce knee osteoarthritis, meniscal injury and subsequent complications compared with nonsurgery after ACL rupture with at least 10 years’ follow-up? A systematic review and meta-analysis. Br J Sports Med. 2020;54(10):592–598. doi: 10.1136/bjsports-2019-100765
  14. Dedes V, Tzirogiannis K, Polikandrioti M, et al. Comparison of radial extractor poreal shockwave therapy with ultrasound therapy in patients with lateral epicondylitis. J Med Ultrason. 2020;47(2):319–325. doi: 10.1007/s10396-019-01002-9
  15. Rubira APFA, Rubira MC, Rubira LA, et al. Comparison of the effects of low-level laser and pulsed and continuous ultrasound on pain and physical disability in chronic non-specific low back pain: a randomized controlled clinical trial. Adv Rheumatol. 2019;59(1):57. doi: 10.1186/s42358-019-0099-z
  16. Hamstra-Wright KL, Huxel Bliven KC, Napier C. Training load capacity, cumulative risk, and bone stress injuries: a narrative review of a holistic approach. Front Sports Act Living. 2021;3:665683. doi: 10.3389/fspor. 2021.665683
  17. Vorobeva IS, Borodulin VB, Nikitina VV, et al. The main mechanisms of pathogenetic development of deforming osteoarthritis. Modern problems of science and education. 2019;(3):121. EDN: WVIAFV
  18. Kotenko KV, Uyba VV, Korchazhkina NB, et al. Instructions for conducting additional methods of examination and rehabilitation of athletes. Moscow; 2012. 25 p. (In Russ.) EDN: QBXBWL
  19. Kotenko KV, Uyba VV, Kortchazhkina NB, et al. Increasing the functional capabilities of the body of athletes in cyclic sports. Occupational Medicine and Industrial Ecology. 2013;(9):42–44. (In Russ.) EDN: RCDVZB
  20. Mikhailova AA, Petrova MS, Petrova VV, et al. Technologies for monitoring the condition of the body of athletes and individuals actively involved in sports. In: Healthy Family — Healthy Generation. Pyatigorsk; 2011. P. 64–65. (In Russ.) EDN: QBFQPB
  21. Aukhadeev EI, Bodrova RA, Vladimirov VS, et al. Sports medicine. Moscow: GEOTAR-Media; 2019. 536 p. (In Russ.) EDN: AHWMHB
  22. Mikhailova AA, Korchazhkina NB, Petrova MS, et al. Modern approaches to monitoring the health condition of students actively involved in sports. In: Rehabilitation and spa treatment-2013: Rehabilitation of patients with comorbid conditions. Moscow; 2013. P. 70. (In Russ.) EDN: RXZCTN
  23. Kulikova NG, Tkachenko AS. Carboxytherapy for spinal and joint degeneration. Moscow: RUDN Publishing Hous; 2024. 250 с. (In Russ.)
  24. Kulikova N, Khalilovich AM, Konchugova T, et al. Analgesic effects of high-frequency and low-frequency TENS currents in patients with distal neuropathy. Eur J Transl Myol. 2022;32(3):10687. doi: 10.4081/ejtm.2022.10687
  25. Al-Zamil MKh, Kulikova N. TENS leads to greater regression of motor deficits in the treatment of facial paralysis. European Journal of Neurology. 2021;28(Suppl 1):EPO-146.
  26. Al-Zamil MKh, Kulikova NG, Minenko I, et al. The use of TENS in the rehabilitation of patients after carpal tunnel decompression. European Journal of Neurology. 2022;29(1):874–874.
  27. Gorbachova T, Melenevsky Y, Cohen M, Cerniglia BW. Osteochondral Lesions of the Knee: Differentiating the Most Common Entities at MRI. Radiographics. 2018;38(5):1478–1495. doi: 10.1148/rg.2018180044
  28. Yuklyaevsky IV. Methodical recommendations for the use of the Aurora apparatus. Saint Petersburg; 2021. 72 p. (In Russ.)
  29. Рarastaev SA, Khokhlina NK, Dergacheva LI, et al. Clinical recommendations on the admission of persons to sports (training and sports competitions) in accordance with the type of sport,sports discipline, age, gender in diseases of the endocrine system. Moscow: FMBA of Russia; 2019. (In Russ.)

补充文件

附件文件
动作
1. JATS XML
下载

版权所有 © Eco-Vector,


СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 86508 от 11.12.2023. 
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ЭЛ № ФС 77 - 80650 от 15.03.2021 г.