Strickland E M, Fares M, Krebs D E, Riley P O, Givens-Heiss D L, Hodge W A, Mann R W
Department of Physical Therapy, Department of Veterans Affairs Medical Center, Boston, MA 02130.
Phys Ther. 1992 Oct;72(10):691-9. doi: 10.1093/ptj/72.10.691.
The authors conducted a two-part study to compare in vivo acetabular contact pressures during the acute and postacute phases of rehabilitation. This report compares in vivo acetabular contact pressures generated during selected "inpatient" rehabilitation activities and their relationship to pain, range of motion, and other clinical indicators. A pressure-instrumented Moore-type endoprosthesis was implanted in a 73-year-old woman who had sustained a femoral neck fracture. Acetabular contact pressures during the first 2 weeks after surgery were rank-ordered. Clinical data, including range of motion, manual muscle test grade, use of pain medication, and independence in gait, were collected simultaneously. Acetabular pressures did not follow the predicted rank order corresponding to the commonly prescribed temporal order of inpatient rehabilitation activities. Isometric hip extension and active hip flexion generated the highest pressures of all the studied activities, including those measured during gait activities. Isometric exercises, therefore, may not be entirely benign preparation for ambulatory activity. Clinical data did not correspond with peak pressure data, suggesting that observed responses to rehabilitation may not be dependable criteria for progressing the acute hip rehabilitation protocol. We discuss applications for rehabilitation programs based on hip contact pressure data as an initial attempt to formulate more defensible rehabilitation approaches for patients with acutely painful hips.
作者进行了一项分为两部分的研究，以比较康复急性期和急性后期体内髋臼接触压力。本报告比较了在选定的“住院”康复活动期间产生的体内髋臼接触压力，以及它们与疼痛、活动范围和其他临床指标的关系。将一个压力测量型摩尔式假体植入一名73岁股骨颈骨折的女性体内。对术后前2周的髋臼接触压力进行排序。同时收集临床数据，包括活动范围、徒手肌力测试等级、止痛药物使用情况和步态独立性。髋臼压力并未遵循与住院康复活动通常规定的时间顺序相对应的预测排序。在所有研究活动中，包括在步态活动中测量的活动，等长髋关节伸展和主动髋关节屈曲产生的压力最高。因此，等长运动可能并非完全是为步行活动进行的无害准备。临床数据与峰值压力数据不相符，这表明观察到的对康复的反应可能不是推进急性髋关节康复方案的可靠标准。我们讨论了基于髋关节接触压力数据的康复计划的应用，作为为急性疼痛性髋关节患者制定更合理康复方法的初步尝试。
