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

doi:10.3877/cma.j.issn.2096-0263.2019.06.002

Abstract

Abstract:

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

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.

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References 15

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, 2^nd 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.

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）
组别	例数	年龄（岁，±s）	男性例（%）	吸烟史例（%）	饮酒史例（%）	股骨颈骨折例（%）	髋关节发育不良例（%）	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

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）
组别	例数	年龄（岁，±s）	男性例（%）	吸烟史例（%）	饮酒史例（%）	股骨颈骨折例（%）	髋关节发育不良例（%）	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

组别	例数	WOMAC评分						Harris评分
		功能		疼痛		僵硬		Harris评分
		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

组别	例数	WOMAC评分						Harris评分
		功能		疼痛		僵硬		Harris评分
		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

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