膝关节置换患者术后自我控制锻炼与持续被动运动对创面及疼痛管理的影响

注册号:

Registration number:

ChiCTR2500113029 

最近更新日期:

Date of Last Refreshed on:

2025-11-24 11:37:19 

注册时间:

Date of Registration:

2025-11-24 00:00:00 

注册号状态:

补注册

Registration Status:

Retrospective registration

注册题目:

膝关节置换患者术后自我控制锻炼与持续被动运动对创面及疼痛管理的影响

Public title:

Effects of Self-Controlled Exercise/Active Exercise Training versus Continuous Passive Motion on Wound Healing and Pain Management in Postoperative Knee Replacement Patients

注册题目简写:

English Acronym:

研究课题的正式科学名称:

膝关节置换患者术后自我控制锻炼/主动运动训练与持续被动运动对创面及疼痛管理的影响

Scientific title:

Effects of Self-Controlled Exercise/Active Exercise Training versus Continuous Passive Motion on Wound Healing and Pain Management in Postoperative Knee Replacement Patients

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

王知 

研究负责人:

王知 

Applicant:

Wang Zhi 

Study leader:

Wang Zhi 

申请注册联系人电话:

Applicant telephone:

+86 18586730830

研究负责人电话:

Study leader's
telephone:

+86 852 23239990

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

wangzhi@zmu.edu.cn

研究负责人电子邮件:

Study leader's E-mail:

wangzhi@zmu.edu.cn

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

中国贵州省遵义市汇川区凤凰北路78号

研究负责人通讯地址:

贵州省遵义市汇川区凤凰北路98号

Applicant address:

78 Fenghuang North Road, Huichuan District, Zunyi, Guizhou, China

Study leader's address:

98 Fenghuang North Road, Huichuan District, Zunyi Province, Guizhou Province, China

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

遵义市第一人民医院

Applicant's institution:

The First People’s Hospital of Zunyi

研究负责人所在单位:

遵义市第一人民医院

Affiliation of the Leader:

The First People's Hospital of Zunyi

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

伦审(2023)-1-217号

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

遵义市第一人民医院医学伦理管理委员

Name of the ethic committee:

The First People's Hospital of Zunyi The Ethics Committee

伦理委员会批准日期:

Date of approved by ethic committee:

2023-09-02 00:00:00

伦理委员会联系人:

谢建雷

Contact Name of the ethic committee:

Xie Jianlei

伦理委员会联系地址:

贵州省遵义市汇川区凤凰北路98号

Contact Address of the ethic committee:

98 Fenghuang North Road, Huichuan District, Zunyi Province, Guizhou Province, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 851 23110546

伦理委员会联系人邮箱:

Contact email of the ethic committee:

836065323@qq.com

研究实施负责(组长)单位:

遵义市第一人民医院

Primary sponsor:

The First People's Hospital of Zunyi

研究实施负责(组长)单位地址:

贵州省遵义市汇川区凤凰北路98号

Primary sponsor's address:

98 Fenghuang North Road, Huichuan District, Zunyi Province, Guizhou Province, China

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

贵州

市(区县):

遵义

Country:

China

Province:

Guizhou

City:

Zunyi

单位(医院):

遵义市第一人民医院

具体地址:

贵州省遵义市汇川区凤凰北路98号

Institution
hospital:

The First People's Hospital of Zunyi

Address:

98 Fenghuang North Road, Huichuan District, Zunyi Province, Guizhou Province, China

经费或物资来源:

遵义市科技计划项目

Source(s) of funding:

Zunyi Municipal Science and Technology Plan Project

研究疾病:

膝关节骨性关节炎  

Target disease:

Knee osteoarthritis

研究疾病代码:

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

其它 

Study phase:

N/A

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

膝关节置换患者术后主动运动训练/自我控制锻炼与持续被动运动对创面及疼痛管理的影响  

Objectives of Study:

The Effect of Postoperative Self-Controlled Exercise/Active Motion Training and Continuous Passive Motion on Wound and Pain Management in Knee Replacement Patients

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

Inclusion criteria

排除标准:

1.有明确外伤史、感染史或膝关节手术史的患者; 2.有严重合并症及深静脉血栓形成的患者; 3.仅接受保守治疗的患者; 4.患有类风湿性关节炎的患者; 5.HIV 阳性患者; 6.合并糖尿病周围神经病变、慢性腰腿痛等可影响评估的疾病; 7.合并免疫系统、血液系统等严重系统性疾病的患者; 8.合并认知功能障碍或存在精神疾病无法配合研究的患者; 9.研究期间因各种原因退出研究的患者

Exclusion criteria:

1. Patients with a clear history of trauma, infection, or knee surgery; 2. Patients with severe comorbidities or deep vein thrombosis; 3. Patients receiving only conservative treatment; 4. Patients with rheumatoid arthritis; 5. HIV-positive patients; 6. Patients with comorbidities such as diabetic peripheral neuropathy or chronic low back and leg pain that may affect assessment; 7. Patients with severe systemic diseases involving the immune or hematologic systems; 8. Patients with cognitive impairment or psychiatric disorders that prevent participation in the study; 9. Patients who withdraw from the study for any reason during the study period.

研究实施时间:

Study execute time:

From 2023-10-01 00:00:00 To 2025-09-30 00:00:00  

征募观察对象时间:

Recruiting time:

From 2024-01-02 00:00:00 To 2024-12-30 00:00:00

干预措施:

Interventions:

组别:

CMP组

样本量:

200

Group:

CMP Group

Sample size:

干预措施:

患者术后返回病房后使用持续性被动运动器(杭州迈迪克仪器有限公司,产品标准:YZB/浙 2021-2009)进行训练,具体方案如下: 1 根据患者下肢长度调整CPM机杆长度; 2 将患肢置于CPM机上,外展位保持10°–20°; 3 CPM机起始角度为30°,每日增加10°; 4 每次伸膝屈膝动作周期为45秒,每次训练持续30分钟,每日2次; 5 持续训练至术后出院。

干预措施代码:

Intervention:

After returning to the ward postoperatively, patients underwent training using a continuous passive motion (CPM) device (Hangzhou Meditech Instruments Co., Ltd., Product Standard: YZB/Zhe 2021-2009), with the following protocol: 1. Adjust the CPM machine rod length according to the patient’s lower limb length; 2. Place the affected limb on the CPM machine in an abduction position of 10°–20°; 3. Set the initial flexion angle at 30°, increasing by 10° daily; 4. Each flexion-extension cycle lasts 45 seconds, with each session lasting 30 minutes, performed twice daily; 5. Continue training until hospital discharge.

Intervention code:

组别:

AET组

样本量:

200

Group:

AET Group

Sample size:

干预措施:

术后返回病房即指导患者进行以下训练: 1. 股四头肌等长收缩配合踝泵训练:背伸或跖屈踝关节,持续10秒后放松,10分钟内完成10次,每小时进行2-3回合; 2. 术后第1天:直腿抬高训练,平卧位,患肢伸直,抬离床面,初始髋关节屈曲约10°,逐渐增加至40°,每次维持10秒; 3. 术后第2天:弯腿训练,患者坐于床边,患侧膝关节屈曲至90°,健侧小腿置于患侧小腿前方,向后施压患侧小腿,维持10秒,每小时进行5-10次; 4. 术后第3天:站立位屈膝锻炼,每次维持10秒,重复5-10次,完成2个回合; 5. 术后第4天:行走训练,初始使用助行器辅助,逐步过渡至独立行走; 6. 术后第5天:上下台阶训练,上、下午各进行2次,每次完成10个台阶; 7. 术后至出院:每日重复上述所有项目,逐步增加训练次数与强度。

干预措施代码:

Intervention:

Immediately upon returning to the ward after surgery, instruct the patient to perform the following exercises: 1. Isometric quadriceps contraction combined with ankle pumps: dorsiflex or plantarflex the ankle, hold for 10 seconds, then relax; complete 10 repetitions within 10 minutes, and perform 2–3 sets per hour. 2. On postoperative day 1: Straight leg raise—lie supine with the affected leg extended, lift it off the bed, starting with hip flexion of approximately 10° and gradually increasing to 40°, holding each position for 10 seconds. 3. On postoperative day 2: Knee flexion exercise—sit at the edge of the bed, flex the affected knee to 90°, place the healthy lower leg in front of the affected lower leg, and apply gentle posterior pressure to the affected calf, maintaining for 10 seconds; perform 5–10 repetitions per hour. 4. On postoperative day 3: Standing knee flexion—stand and flex the knee, holding each position for 10 seconds; repeat 5–10 times, completing 2 sets. 5. On postoperative day 4: Walking training—begin with assistance from a walker, gradually transitioning to independent ambulation. 6. On postoperative day 5: Stair climbing—perform 2 sessions per day (morning and afternoon), completing 10 steps per session. 7. From postoperative day 1 until discharge: Repeat all above exercises daily, progressively increasing the frequency and intensity of training.

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

贵州 

市(区县):

遵义 

Country:

China

Province:

Guizhou

City:

Zunyi

单位(医院):

遵义市第一人民医院 

单位级别:

三级甲等 

Institution
hospital:

The First People's Hospital of Zunyi

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

手术伤口外观评分(SWAS)

指标类型:

主要指标

Outcome:

Surgical Wound Appearance Score (SWAS)

Type:

Primary indicator

测量时间点:

术后第1天,3天,7天,2周

测量方法:

Measure time point of outcome:

Postoperative Day 1, Day 3, Day 7, and Week 2

Measure method:

指标中文名:

美国特种外科医院膝关节评分

指标类型:

主要指标

Outcome:

HSS Score

Type:

Primary indicator

测量时间点:

术前、术后第7天,术后1月、术后3月、术后6月

测量方法:

Measure time point of outcome:

Before surgery, Postoperative Day 7, Postoperative Month 1, 3, 6

Measure method:

指标中文名:

主动关节活动度(AROM)

指标类型:

主要指标

Outcome:

Active Range of Motion (AROM)

Type:

Primary indicator

测量时间点:

术前、术后第7天,术后1月、术后3月、术后6月

测量方法:

Measure time point of outcome:

Before surgery, Postoperative Day 7, Postoperative Month 1, 3, 6

Measure method:

指标中文名:

视觉疼痛模拟法(VAS)

指标类型:

主要指标

Outcome:

Visual Analog Scale (VAS)

Type:

Primary indicator

测量时间点:

术前、术后第1天,3天,7天,术后1月、术后3月、术后6月

测量方法:

Measure time point of outcome:

Before surgery, Postoperative Day 1, Day 3, Day 7, Postoperative Month 1, 3, 6

Measure method:

指标中文名:

静态平衡能力(SBA)

指标类型:

主要指标

Outcome:

Static balance ability

Type:

Primary indicator

测量时间点:

术前、术后第7天,术后1月、术后3月

测量方法:

Measure time point of outcome:

Before surgery, Postoperative Day 7, Postoperative Month 1, 3

Measure method:

指标中文名:

起立-步行计时测试(TUGT)

指标类型:

主要指标

Outcome:

Timed Up and Go Test (TUG Test)

Type:

Primary indicator

测量时间点:

术前、术后第7天,术后1月、术后3月、术后6月

测量方法:

Measure time point of outcome:

Before surgery, Postoperative Day 7, Postoperative Month 1, 3, 6

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

组织:

Sample Name:

None

Tissue:

人体标本去向

其它  

说明

Fate of sample:

0thers  

Note:

征募研究对象情况:

Recruiting status:

结束

/Completed

年龄范围:

Participant age:

最小 Min age years
最大 Max age years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

采用计算机生成的随机数字表,将参与者按 1:1 比例随机分配至主动运动训练(( AET)组或持续被动运动(CPM)组。随机分配序列由 不参与患者临床管理的研究人员生成并管理,以确保分配隐藏。

Randomization Procedure (please state who generates the random number sequence and by what method):

Participants were randomly allocated to either the Active Exercise Training (AET) group or Continuous Passive Motion (CPM) group at a 1:1 ratio using a computer-generated random number table. The randomization sequence was generated and managed by researchers who were not involved in patient clinical management to ensure allocation concealment.

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

不公开/Private

盲法:

双盲,对受试者和研究者均隐藏分组信息

Blinding:

Double-blind: Group allocation information is concealed from both participants and investigators.

是否共享原始数据:

IPD sharing

是Yes

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

研究结束并课题文章发表后半年内,数据在ResMan(http://www.medresman.org.cn/)

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

De-identified IPD will be available upon approval by the Data Access Committee. Applicants must submit a proposal and sign a Data Use Agreement. Data will be hosted on ResMan (http://www.medresman.org.cn/), and access will be provided within 30 days of approval, starting 6 months after publication.

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

共采用两种方式:1.病例记录表(Case Record Form,CRF;2.电子采集和管理系统(Electronic Data Capture,EDC)

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Data collection was performed using Case Record Forms (CRF) and Electronic Data Capture (EDC) systems, ensuring multiple verification channels and comprehensive data integrity.

数据与安全监察委员会:

Data and Safety Monitoring Committee:

有/Yes

注册人:

Name of Registration:

 2025-11-24 11:37:19