全膝关节置换术后恐动症干预策略的范围综述

杨琳; 舒静; 曹力震

doi:10.16766/j.cnki.issn.1674-4152.004389

全膝关节置换术后恐动症干预策略的范围综述

doi: 10.16766/j.cnki.issn.1674-4152.004389

湖北中医药大学护理学院，湖北武汉 430065

基金项目:

湖北省中医药管理局2023~2024年度中医药科研项目 ZF2023F131

详细信息

通讯作者:
舒静，E-mail：jingjing1203@sina.com

中图分类号: R687.4 R473.6
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- 文章访问数: 6
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出版历程
- 收稿日期: 2025-02-01
- 网络出版日期: 2026-04-11

A scoping review of intervention strategies for kinesiophobia after total knee arthroplasty

School of Nursing, Hubei University of Chinese Medicine, Wuhan, Hubei 430065, China

摘要

摘要: 目的对全膝关节置换术后恐动症干预策略研究进行范围审查，归纳总结不同干预策略实施形式、内容及其结论，以期为学者和医护人员未来进一步研究提供参考。方法以范围综述的方法对PubMed、Embase、Web of Science、Cochrane Library、中国知网、维普、万方和生物医学文献服务等数据库进行系统检索，时限为建库至2023年12月，收集全膝关节置换术后恐动症干预策略相关文献，对纳入文献进行汇总和描述性分析。结果初步检索到1 247篇文献，经过剔去重复文献及不符合纳入标准文献，最终纳入21篇文献，发表于2013—2023年，其中中文15篇，英文6篇，包括认知行为干预疗法、功能锻炼、观看视频、疼痛日记、多学科协作5个类型。干预地点包括医院和家庭，干预周期、频次具有较大差异。结局指标包括恐动症程度、疼痛程度、心理状态、膝关节活动能力等多个方面。结论不同的干预策略对患者的恐动情况和心理健康状态均有不同程度的改善，但目前没有公认治疗效果最佳的干预方式，未来研究应注重探索最佳的恐动症干预策略，制定统一规范的评价标准，根据患者实际情况及医疗资源选择和制定科学规范的干预策略。
- 全膝关节置换术 /
- 恐动症 /
- 干预策略 /
- 范围综述
Abstract: Objective A scoping review of research on intervention strategies for kinesiophobia after total knee arthroplasty was conducted to summarize the form and content of the different strategies implemented and their conclusions, with a view to informing further research by academics and healthcare professionals in the future. Methods A systematic search of the following databases was conducted in: PubMed, Embase, Web of Science, Cochrane Library, China Knowledge, Wipro, Wanfang and Biomedical Literature Service. The search was conducted with the aim of conducting a scoping review, and the timeframe for the construction of the database was taken into consideration. The end point of the timeframe was to December 2023. The objective of the review was to collect literature related to intervention strategies for kinesiophobia after total knee arthroplasty. The included literature was then summarized and analyzed descriptively. Results Initially, 1 247 papers were retrieved, and after eliminating duplicates and papers that did not meet the inclusion criteria, 21 papers were finally included, published from 2013-2023, including 15 in Chinese and 6 in English, including 5 types of cognitive-behavioral intervention therapies, functional exercises, watching videos, pain diaries, and multidisciplinary collaboration. Conclusion The effectiveness of different intervention strategies in improving patients' kinesiophobia and mental health status varies, yet no intervention has been identified as optimal therapeutic option. Future research should concentrate on exploring the most effective intervention strategies for kinesiophobia, developing uniform and standardized evaluation criteria, and selecting and developing scientific and standardized intervention strategies based on patients' actual conditions and medical resources.
- Total knee arthroplasty /
- Kinesiophobia /
- Intervention strategies /
- Scope review

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图 1 文献检索筛选流程

Figure 1. Retrieval screening process

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表 1 纳入文献基本特征

Table 1. Basic characteristics of the included literature

纳入文献	发表时间	国家	研究类型	干预策略/干预内容	结局指标
MONTICONE M^[32]	2013	意大利	A	家庭功能锻炼/功能锻炼，60 min/次，2次/周，持续6个月	①②③④
RUSSO L R^[33]	2017	意大利	A	视频心理强化/术后15 d内的康复课程前播放艺术视频，随后4周，3次/周	①⑤⑥⑦⑧
CAI L^[17]	2018	中国	A	CBT/为期4周的认知行为疗法程序	①②⑨
李薇^[18]	2018	中国	A	CBT/分析恐动原因，针对性地进行干预，指导患者逐步康复锻炼	①⑦
朱俊美^[19]	2019	中国	A	疼痛日记及个体化疼痛干预/根据日记内容实施个体化疼痛干预	①⑨
蔡立柏^[20]	2020	中国	B	多学科协作干预方案/组建多学科协作团队制订个体化干预方案	①②⑨⑫
曹雪晶^[21]	2020	中国	B	基于认知行为干预的快速康复理念/通过评估制定快速康复目标，纠正错误认知，采取行为干预	①②⑦
李海云^[22]	2020	中国	A	Otago运动/Otago运动训练	①⑨⑩
TEISSIER V^[36]	2020	法国	A	离心、向心结合康复训练/在向心训练的基础上进行3次/周的离心运动	①⑨
LU G^[23]	2021	中国	B	微视频干预/在微视频播放期间提供认知信念教育和运动行为要点指导	①②⑪⑫
郭玉茹^[24]	2021	中国	B	功能锻炼决策辅助/患者自主选择康复方案	①⑦
朱俊美^[25]	2021	中国	B	CBT/认知行为团体进行心理干预	①⑧⑨⑫
李晓辉^[26]	2022	中国	A	早期量化康复训练联合疼痛管理/早期量化康复训练和疼痛管理	①⑫
EYMIR M^[34]	2022	土耳其	B	放松运动疗法/术后第1、2、3天进行渐进性肌肉放松练习	①②⑩
周岑^[27]	2022	中国	A	Otago运动/Otago运动训练	①⑩⑪
CICI R^[35]	2023	土耳其	A	观看喜剧电影、听冥想音乐/术后第1天观看喜剧电影或听冥想音乐20 min	①⑧
李玉^[29]	2023	中国	A	功能锻炼决策辅助干预/患者自行选择康复锻炼方案	①
钱思琪^[30]	2023	中国	A	CBT/纠正错误认知，进行行为、恐动干预	①②⑦⑫
张丽^[31]	2023	中国	A	CBT/进行认知干预和行为干预	①⑤⑦⑫
陈建潇^[28]	2023	中国	A	视频辅助出院教育方案/手术前观看出院教育视频	①⑧⑨
GÜR O^[14]	2023	土耳其	A	VR/每周2次连续3周，运动前观看步行视频	①⑤
注：A为随机对照研究，B为类实验研究；结局指标如下，①TSK；②疼痛数字评估表；③膝关节损伤和骨关节炎评分表；④生活质量评分表；⑤健康调查简表；⑥状态-体质焦虑量表；⑦膝关节协会评分量表；⑧视觉模拟量表；⑨膝关节功能量表；⑩ Berg平衡量表；⑪日常生活活动能力量表；⑫首次下床时间。

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参考文献(40)

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