Norwegian Research Center for Active Rehabilitation (NAR), Department of Orthopedics, Oslo University Hospital and Hjelp24 Norwegian Sports Medicine Clinic (Hjelp24 NIMI), Oslo, Norway.
J Orthop Sports Phys Ther. 2010 Oct;40(10):616-24. doi: 10.2519/jospt.2010.3346.
Cross-sectional study.
To compare functioning and disability in patients with hip osteoarthritis (OA) not candidates for surgery, to a matched control group, and thereby to examine the relationship between the functioning and disability components used in this study in patients with hip OA.
It is well known that patients with severe hip OA have deficits in functioning and disability. However, in patients with hip OA not candidates for surgery, the knowledge regarding functioning and disability is sparse.
Twenty-six patients (12 men, 14 women; mean age, 60 years) with radiographic and symptomatic hip OA were matched to 26 controls without hip pain. The following variables were measured: muscle strength using isokinetic peak force, hip passive range of motion, submaximal aerobic capacity using a cycling test, walking ability using the 6-minute walk test, self-reported pain, stiffness, and physical function using the Western Ontario and McMaster University Osteoarthritis Index, and health-related quality of life using the SF-36.
The patients with hip OA had mild to moderate pain, as indicated by the Western Ontario and McMaster University Osteoarthritis Index, and significantly lower knee extension strength (mean difference [95% confidence interval {CI}]: -19.5 [-34.3, -4.7] Nm). Hip range of motion was significantly less in the patients with hip OA, with mean (95% CI) differences of -10° (-14°, -6°) for extension, -18° (-26°, -11°) for flexion, -9° (-14°, -4°) for abduction, -2° (-5°, 0°) for adduction, -16° (-23°, -9°) for internal rotation, and -21° (-28°, -14°) for external rotation. The patients with hip OA walked a significantly shorter distance in 6 minutes (mean difference, -75 m; 95% CI: -131, -20 m). There were no significant differences in hip extension/flexion, knee flexion, ankle dorsiflexion/plantar flexion muscle strength, or aerobic capacity between the 2 groups. There were significant associations between body function and activity components.
Physical therapists should consider including quadriceps-strengthening and hip range-of-motion exercises when developing rehabilitation programs for patients with hip OA, with mild to moderate pain, aiming to improve functioning and reduce disability.
横断面研究。
比较髋骨关节炎（OA）非手术患者的功能和残疾状况，并与匹配对照组进行比较，从而探讨本研究中用于髋 OA 患者的功能和残疾成分之间的关系。
众所周知，严重髋 OA 患者的功能和残疾存在缺陷。然而，对于髋 OA 非手术患者，其对功能和残疾的认识尚不清楚。
26 名患者（12 名男性，14 名女性；平均年龄 60 岁）有放射影像学和症状性髋 OA，并与 26 名无髋痛的对照组相匹配。测量以下变量：使用等速峰值力测量肌肉力量，髋关节被动活动范围，使用踏车试验测量亚最大有氧能力，使用 6 分钟步行测试测量步行能力，使用 Western Ontario 和 McMaster 大学骨关节炎指数测量自我报告的疼痛、僵硬和身体功能，以及使用 SF-36 测量健康相关生活质量。
患者的髋 OA 表现为轻度至中度疼痛，Western Ontario 和 McMaster 大学骨关节炎指数表明，膝关节伸展力量明显降低（平均差异[95%置信区间（CI）]：-19.5 [-34.3，-4.7] Nm）。患者的髋关节活动范围明显减小，伸展时平均（95%CI）差异为-10°（-14°，-6°），屈曲时为-18°（-26°，-11°），外展时为-9°（-14°，-4°），内收时为-2°（-5°，0°），内旋时为-16°（-23°，-9°），外旋时为-21°（-28°，-14°）。患者在 6 分钟内行走的距离明显缩短（平均差异，-75m；95%CI：-131，-20m）。两组间髋关节伸展/屈曲、膝关节屈曲、踝关节背屈/跖屈肌肉力量或有氧能力无显著差异。身体功能和活动成分之间存在显著关联。
对于有轻度至中度疼痛的髋 OA 患者，物理治疗师在制定康复计划时应考虑包括股四头肌强化和髋关节活动范围练习，以改善功能并减少残疾。
