Institute of Health and Society, University of Oslo, Oslo, Norway.
Arthritis Care Res (Hoboken). 2012 Mar;64(3):415-23. doi: 10.1002/acr.20681.
OBJECTIVE: To investigate the effect of a 12-session walking skill training program of weight-bearing activities on physical functioning and self-efficacy initiated in patients 3 months after total hip arthroplasty (THA). METHODS: Sixty-eight patients with THA, 35 women and 33 men, with a mean age of 66 years (95% confidence interval [95% CI] 64, 67 years), were randomized to a training group (n = 35) or a control group without physiotherapy (n = 33). Assessments were performed before the intervention at 3 months (pretest), at 5 months (posttest 1), and at 12 months (posttest 2) after surgery. The primary outcome was the 6-minute walk test (6MWT). The secondary outcomes were the stair climbing test (ST); figure-of-eight test; Index of Muscle Function (IMF); active hip range of motion (ROM) in flexion, extension, and abduction; Harris Hip Score (HHS); self-efficacy; and Hip Dysfunction and Osteoarthritis Outcome Score. RESULTS: The training group had larger improvements than the control group at posttest 1 on the 6MWT with an adjusted mean difference of 52 meters (95% CI 29, 74 meters; P < 0.001) and on the ST of -1 second (95% CI -2, 0 seconds; P = 0.01).There were also improvements on the figure-of-eight test (P = 0.02), IMF (P = 0.001), active hip ROM in extension (P = 0.02), HHS (P = 0.05), and self-efficacy (P = 0.04). The difference between the groups persisted at posttest 2 on the 6MWT of 52 meters (95% CI 24, 80 meters; P < 0.001) and on the ST of -1 second (95% CI -3, 0 seconds; P = 0.05). CONCLUSION: The walking skill training program was effective, especially in improving walking both immediately after the intervention and 1 year after THA surgery.
目的:研究在全髋关节置换术后 3 个月开始的 12 节负重活动步行技能训练方案对身体功能和自我效能的影响。
方法:68 名全髋关节置换术后患者(35 名女性和 33 名男性),平均年龄 66 岁(95%置信区间 [95%CI] 64, 67 岁),随机分为训练组(n = 35)或无物理治疗的对照组(n = 33)。评估在干预前(术前)、术后 5 个月(术后 1 次)和 12 个月(术后 2 次)进行。主要结局是 6 分钟步行试验(6MWT)。次要结局包括爬楼梯试验(ST);八字试验;肌肉功能指数(IMF);主动髋关节屈伸和外展活动度;髋关节功能评分(HHS);自我效能感;髋关节功能障碍和骨关节炎结果评分。
结果:与对照组相比,训练组在术后 1 次时 6MWT 有更大的改善,调整后的平均差异为 52 米(95%CI 29, 74 米;P <0.001)和 ST 增加 1 秒(95%CI -2, 0 秒;P = 0.01)。八字试验(P = 0.02)、IMF(P = 0.001)、主动髋关节伸展活动度(P = 0.02)、HHS(P = 0.05)和自我效能感(P = 0.04)也有改善。在术后 2 次时,6MWT 的 52 米差异(95%CI 24, 80 米;P <0.001)和 ST 的 1 秒差异(95%CI -3, 0 秒;P = 0.05)仍然存在。
结论:步行技能训练方案是有效的,尤其是在改善全髋关节置换术后即刻和 1 年的步行能力方面。
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