早期持续髋周肌抗阻训练对全髋关节置换术后功能的影响

摘要

Objective To explore the effectiveness of early continuous hip muscle resistance exercise on post-operative pain relief and function restoring after total hip arthroplasty (THA).Methods 45 patients after THA were randomly divided into 2 groups:observation group (n =23) and control group (n =22).routine rehabilitation treatment was applied to patients in both groups while early continuous hip muscle resistance exercise was added to patients in observation group;evaluation of the patients was made with visual analogue scale (VAS) and Harris scores at the time point of 1 day,1 week and 3 months after operation.Results The VAS and Harris scores of the patients in the 2 groups 1 day after operation were of no statistical difference from those 1 week after operation;the VAS scores of the patients in observation group 3 months after operation were much lower than those of the patients in control group (P＜0.05);there existed a great statistical difference in pain and walking distance in Harris scores between the 2 groups (P＜0.05),the differences in scores of daily living,walking support and in total scores were obvious (P＜0.01),the evaluation in observation group was superior to that of control group.Conclusions Early continuous hip muscle resistance exercise is of help in relieving pain and improving function of the patients after THA.%目的 探索术后早期持续髋部周围肌肉抗阻训练对全髋关节置换(total hip arthroplasty,THA)患者疼痛及功能的影响.方法 45例THA患者随机分为对照组(n=22)与试验组(n=23),对照组采用常规康复训练疗法,试验组除采用与对照组相同的常规康复训练外,自术后第1天至3个月增加髋周肌抗阻训练.采用视觉模拟评分(visual analoguescale,VAS)及Harris评分分别于术后第1天、1周及术后3个月时评估患者情况.结果 术后1周时与术后第1天相比,2组在VAS与Harris评分各项目上差异均无统计学意义.术后第3个月时,试验组的VAS评分显著低于对照组(P＜0.05);在Harris评分中,2组在疼痛和行走距离上存在显著差异(均P＜0.05),日常活动、助行器具以及总分的差异均非常显著(均P＜0.01),试验组明显优于对照组.结论 通过术后早期持续髋部周围肌肉抗阻训练对THA患者进行增强康复治疗,在术后3个月时,试验组的VAS评分及Harris评分都显著或非常显著优于对照组,表明THA术后,在常规康复训练的基础上,增加早期持续髋周肌抗阻训练,可以降低患者疼痛感受,更好恢复髋关节功能,具有临床推广价值.