Rahmann Ann E, Brauer Sandra G, Nitz Jennifer C
Division of Physiotherapy, School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, Qld, Australia.
Arch Phys Med Rehabil. 2009 May;90(5):745-55. doi: 10.1016/j.apmr.2008.12.011.
To evaluate the effect of inpatient aquatic physiotherapy in addition to usual ward physiotherapy on the recovery of strength, function, and gait speed after total hip or knee replacement surgery.
Pragmatic randomized controlled trial with blinded 6-month follow-up.
Acute-care private hospital.
People (n=65) undergoing primary hip or knee arthroplasty (average age, 69.6+/-8.2y; 30 men).
Participants were randomly assigned to receive supplementary inpatient physiotherapy, beginning on day 4: aquatic physiotherapy, nonspecific water exercise, or additional ward physiotherapy.
Strength, gait speed, and functional ability at day 14.
At day 14, hip abductor strength was significantly greater after aquatic physiotherapy intervention than additional ward treatment (P=.001) or water exercise (P=.011). No other outcome measures were significantly different at any time point in the trial, but relative differences favored the aquatic physiotherapy intervention at day 14. No adverse events occurred with early aquatic intervention.
A specific inpatient aquatic physiotherapy program has a positive effect on early recovery of hip strength after joint replacement surgery. Further studies are required to confirm these findings. Our research indicates that aquatic physiotherapy can be safely considered in this early postoperative phase.
评估在常规病房物理治疗基础上，住院期水疗物理治疗对全髋关节或全膝关节置换术后力量、功能及步态速度恢复的影响。
实用随机对照试验，随访6个月且设盲。
急性护理私立医院。
65例接受初次髋或膝关节置换术的患者（平均年龄69.6±8.2岁；男性30例）。
参与者被随机分配接受补充住院物理治疗，从第4天开始：水疗物理治疗、非特异性水上运动或额外的病房物理治疗。
第14天时的力量、步态速度和功能能力。
在第14天，水疗物理治疗干预后的髋外展肌力量显著大于额外的病房治疗（P = 0.001）或水上运动（P = 0.011）。在试验的任何时间点，其他观察指标均无显著差异，但在第14天相对差异有利于水疗物理治疗干预。早期水疗干预未发生不良事件。
特定的住院期水疗物理治疗方案对关节置换术后髋关节力量的早期恢复有积极作用。需要进一步研究来证实这些发现。我们的研究表明，在术后早期阶段可安全考虑水疗物理治疗。
