TRAUMA
Accelerated versus nonaccelerated rehabilitation after anterior cruciate ligament reconstruction: A prospective, randomized, double-blind investigation evaluating knee joint laxity using roentgen stereophotogrammetric analysis
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OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2013;1(11):342 Am J Sports Med. 2011 Dec;39(12):2536-48. Epub 2011 Sep 2742 patients undergoing ACL reconstruction were randomized to receive either an accelerated or non accelerated rehabilitation program to determine their effects on knee envelop laxity. At 2 year follow-up, there was a significant increase in knee envelope laxity compared to initial post-surgical measures in both groups. There were no differences in terms of laxity, clinical, functional, or strength outcomes between the rehabilitation programs.
Was the allocation sequence adequately generated?
Was allocation adequately concealed?
Blinding Treatment Providers: Was knowledge of the allocated interventions adequately prevented?
Blinding Outcome Assessors: Was knowledge of the allocated interventions adequately prevented?
Blinding Patients: Was knowledge of the allocated interventions adequately prevented?
Was loss to follow-up (missing outcome data) infrequent?
Are reports of the study free of suggestion of selective outcome reporting?
Were outcomes objective, patient-important and assessed in a manner to limit bias (ie. duplicate assessors, Independent assessors)?
Was the sample size sufficiently large to assure a balance of prognosis and sufficiently large number of outcome events?
Was investigator expertise/experience with both treatment and control techniques likely the same (ie.were criteria for surgeon participation/expertise provided)?
はい = 1
不確実＝0.5
無関係 = 0
いいえ = 0
報告基準評価では、著者が出版物内で試験の方法論的特徴や試験特性を報告する際の透明性を評価します。評価は以下の5つのカテゴリーに分類されます。
4/4
Randomização
4/4
Medidas de resultado
4/4
Inclusão/Exclusão
4/4
Descrição do tratamento
4/4
Estatística
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
Fragility Indexは、重要な所見の解釈を助けるツールで、結果の強さの尺度を提供します。Fragility Indexは、その所見が有意でなくなるために、二項対立の結果に追加する必要がある連続した事象の数を表します。数値が小さいほど弱い所見を表し、数値が大きいほど強い所見を表します。
なぜ今この研究が必要なのですか？
The relationship between duration of rehabilitation exercise program and healing response of the knee is not fully understood. This study examined the effects of an accelerated versusa non- accelerated rehabilitation program on knee envelope laxity in patients who have undergone ACL reconstruction.
主な研究課題は何ですか？
Does an accelerated rehabilitation program produce similar joint laxity outcomes compared to a non accelerated program for patients who have undergone ACL reconstruction?
重要な知見は？
- Both groups demonstrated an increase in anterior-posterior laxity over the 2 year period
- The accelerated group demonstrated an increase in thigh muscle strength at 3 months (p<0.05), but this difference diminished at later follow-ups
- There were no differences in patient satisfaction, clinical, functional, proprioception, and muscle strength outcomes
最も覚えておくべきことは？
There were similar increases in knee envelope laxity during the 2 year follow-up in both groups. Both rehabilitation methods produced similar clinical, functional, and patient satisfaction outcomes.
それが私の患者ケアにどのように影響するか？
Both rehabilitation programs produced similar results. The rehabilitation program should be chosen based on patient and physician preference.
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