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中华老年骨科与康复电子杂志

中华老年骨科与康复电子杂志 ›› 2019, Vol. 05 ›› Issue (06) : 312 -316. doi: 10.3877/cma.j.issn.2096-0263.2019.06.002

所属专题： 文献；

关节

功率自行车对老年髋关节置换患者术后早期功能恢复的疗效分析
高磊1, 瞿玉兴1,†(), 高益1, 沈鹏飞1, 王斌1, 郑冲1, 徐建达1, 谢子康1   
  1. 1. 213000　南京中医药大学附属常州市中医院骨科
  • 收稿日期:2018-11-20 出版日期:2019-12-05
  • 通信作者: 瞿玉兴
  • 基金资助:
    江苏省中医药局科技项目(LZ11137)

Efficacy analysis of postoperative cycle ergometer program for elderly total hip arthroplasty patients

Lei Gao1, Yuxing Qu1,†(), Yi Gao1, Pengfei Shen1, Bin Wang1, Chong Zheng1, Jianda Xu1, Zikang Xie1   

  1. 1. Department of Orthopaedics, Affiliated Hospital of Nanjing university of Traditional Chinese Medicine, Changzhou 21300, China
  • Received:2018-11-20 Published:2019-12-05
  • Corresponding author: Yuxing Qu
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高磊, 瞿玉兴, 高益, 沈鹏飞, 王斌, 郑冲, 徐建达, 谢子康. 功率自行车对老年髋关节置换患者术后早期功能恢复的疗效分析[J]. 中华老年骨科与康复电子杂志, 2019, 05(06): 312-316.

Lei Gao, Yuxing Qu, Yi Gao, Pengfei Shen, Bin Wang, Chong Zheng, Jianda Xu, Zikang Xie. Efficacy analysis of postoperative cycle ergometer program for elderly total hip arthroplasty patients[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2019, 05(06): 312-316.

目的

探讨早期下肢功率自行车应用对老年髋关节置换患者功能恢复的影响。

方法

前瞻性收集南京中医药大学附属常州市中医院骨科150例行髋关节置换术后两周的患者，根据纳入标准，纳入87例患者，随机分为常规组及常规+自行车训练组。常规训练组患者在康复治疗师指导下进行常规康复训练，常规+自行车训练组患者在常规康复训练基础上进行下肢功率自行车训练。两组患者都于术后8 w、4个月分别采用Harris评分及WOMAC量表对髋关节及全身健康状况进行评定。

结果

两组患者在治疗过程中均未出现严重并发症。WOMAC评分：术后8 w常规+自行车训练组患者髋关节僵硬程度[（26±20）分]较对照组[（26±23）分]改善明显，差异有统计学意义（t=9.765，P<0.05），功能及疼痛评分差异均无统计学意义。术后4个月WOMAC各项评分提示，常规+自行车训练组患者功能[（22±18）分]优于常规训练组[（25±19）分]，差异具有统计学意义（t=5.434，P<0.05）。Harris评分：术后8 w及4个月常规+自行车训练组[（82±6）分、（88±12）分]高于同期常规康复训练组[（86±6）分、（82±6）分]，差异具有统计学意义（P<0.05）。

结论

老年髋关节置换患者术后早期进行常规康复训练及功率自行车训练，能显著改善患者疼痛及促进患者术后髋关节功能恢复。

关键词: 功率自行车, 关节成形术，置换，髋, 康复
Objective

To evaluate the effect of cycle ergometer program for elderly total hip arthroplasty (THA) patients.

Methods

Prospective collected 150 patients underwent hip arthroplasty in the Department of Orthopaedics, Changzhou Hospital of Traditional Chinese Medicine, affiliated to Nanjing University of Chinese Medicine. Eighty-seven older patients who had received primary hip replacement were included in the study. Patients were divided into 2 treatment groups randomly. Conventional group performed only conventional exercises, and experimental group performed cycle ergometer and conventionalexercises. Patients were evaluated by Hip function and health-related quality of life were evaluated by Harris Hip Score and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at 8 weeks and 4months after surgery.

Results

There were no serious complications in the treatment of the two groups. WOMAC score: The degree of hip stiffness was (26±20) in experimental group at postoperative 8 weeks, which was significantly improved than that in the regulartraining group (26±23), results was statistically significant (t=9.765, P<0.05). There was no significant difference in functional and pain scores. The WOMAC scores at 4months postoperatively showed that the recovery degree of the experimental group (22±18) was significantly improved compared with the regular training group (25±19), and the difference was statistically significant(t=5.434, P<0.05). Harris score at 8 weeks and 4 months of the experimental group (82±6, 88±12) was higher than the regular training group (86±6, 82±6), the difference was statistically significant (P<0.05).

Conclusion

The rehabilitation including cycle ergometer can improve elderly patients' pain and function after the THA.

Key words: Bicycle exercise, Hip, Joint replacement, Rehabilitation
图1 全膝关节置换术患者采用下肢功率自行车训练
表1 全膝关节置换术前一般基线资料比较
组别 例数 人口学特征 股骨颈骨折例（%） 髋关节发育不良例（%） WOMAC评分（分，±s）
年龄（岁，±s） 男性例（%） 吸烟史例（%） 饮酒史例（%） 功能 疼痛 僵硬
常规训练组 41 72±5 17（41.5） 13（31.7） 19（46.3） 16（39.0） 14（34.1） 55±22 54±26 52±28
常规+自行车训练组 46 72±7 18（39.2） 15（32.6） 21（45.7） 21（45.7） 13（28.3） 53±24 54±24 51±27
统计值   t=1.460 χ2=0.167 χ2=-12.02 χ2=-8.178 χ2=-9.416 χ2=-5.617 t=7.776 t=2.738 t=3.127
P值   0.980 0.683 0.653 0.673 0.490 0.519 0.413 0.378 0.614
表2 两组全膝关节置换术患者术后8 w及4个月WOMAC及Harris评分比较（分，±s）
组别 例数 WOMAC评分 Harris评分
功能 疼痛 僵硬
术后8 w 术后4个月 术后8 w 术后4个月 术后8 w 术后4个月 术后8 w 术后4个月
常规训练组 41 23±18 19±17 16±18 14±16 26±23 25±19 82±6 86±6
常规+自行车训练组 46 23±18 19±15 17±15 11±12 26±20 22±18 82±6 88±12
t值   -14.370 4.371 -10.871 8.965 9.765 5.434 -9.861 10.776
P值   0.697 0.002 0.563 <0.01 0.011 <0.01 0.005 <0.01
1
Bagarié I, Sarac H, Borovac JA, et al. Primary total hip arthroplasty: health related quality of life outcomes [J]. Int Orthop, 2014, 38(3): 495-501.
2
Rampazo MK, D’Elboux MJ. The influence of sociodemographic, clinical and functional variables on the quality of life of elderly people with total hip arthroplasty [J]. Rev Bras Fisioter, 2010, 14(3): 244-251.
3
Wood GC, Mclauchlan GJ. Outcome assessment in the elderly after total hip arthroplasty [J]. J Arthroplasty, 2006, 21(3): 398-404.
4
Ritterman S, Rubin LE. Rehabilitation for total joint arthroplasty [J]. R I Med J, 2013, 96(5): 19-22.
5
Brown GA. AAOS clinical practice guideline of osteoarthritis of the knee: evidence-based guideline, 2nd edition [J]. J Am Acad Orthop Surg, 2013, 21(9): 577-579.
6
Schwachmeyer V, Damm P, Bender A, et al. In vivo hip joint loading during post-operative physiotherapeutic exercises [J]. 2013, 8(10): e77807.
7
Soderman P. On the validity of the results from the Swedish national total hip arthroplasty register [J]. Acta Orthop Scand Suppl, 2000, 71(296): 1-33.
8
Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fracture: treatment by mold arthroplasty, an end-result study using a new method of result evaluation [J]. J Bone Joint Surg, 1969, 51(4): 737-755.
9
Peter WF, Nelissen RG, Vliet Vlieland TP. Guideline recommendations for post-acute postoperative physiotherapy in total hip and knee arthroplasty: are they used in daily clinical practice [J]. Musculoskeletal Care, 2014, 12(3): 125-131.
10
Geissler A, Scheller-Kreinsen D, Quentin W, et al. Do diagnosis-related groups appropriately explain variations in costs and length of stay of hip replacement [J]. Health Econ, 2012, 21 Suppl2: 103-115.
11
陈晟，戴闽，帅浪,等.早期运动治疗对全髋关节置换术后髋关节功能的影响[J].中华物理医学与康复杂志, 2009, 31(6): 411-413.
12
Judd DL, Dennis DA, Thomas AC, et al. Muscle strength and functional recovery during the first year after THA [J]. Clin Orthop Relat Res, 2014, 472(2): 654-664.
13
Di Monaco M, Vallero F, Tappero R, et al. Rehabilitation after total hip arthroplasty: a systematic review of controlled trials on physical exercise programs [J]. Eur J Phys Rehabil Med, 2009, 45(3): 303-317.
14
毕胜，燕铁斌，王宁华,等.运动控制原理与实践[M].第3版.北京:人民卫生出版社, 2009: 4-16.
15
周开颜，王莉，喻宏.人工全髋关节置换围手术期的教育康复[J].中国康复, 2003, 18(1): 63.
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