全膝关节和髋关节置换术后疼痛灾难化、肌肉力量与身体功能之间的关联。
Associations among pain catastrophizing, muscle strength, and physical performance after total knee and hip arthroplasty.
作者信息
Hayashi Kazuhiro, Kako Masato, Suzuki Kentaro, Hattori Keiko, Fukuyasu Saori, Sato Koji, Kadono Izumi, Sakai Tadahiro, Hasegawa Yukiharu, Nishida Yoshihiro
机构信息
Kazuhiro Hayashi, Masato Kako, Kentaro Suzuki, Keiko Hattori, Saori Fukuyasu, Koji Sato, Izumi Kadono, Yoshihiro Nishida, Department of Rehabilitation, Nagoya University Hospital, Aichi 466-8550, Japan.
出版信息
World J Orthop. 2017 Apr 18;8(4):336-341. doi: 10.5312/wjo.v8.i4.336.
AIM
To investigate whether reductions in pain catastrophizing associated with physical performance in the early period after total knee arthroplasty (TKA) or total hip arthroplasty (THA).
METHODS
The study group of 46 participants underwent TKA or THA. The participants were evaluated within 7 d before the operation and at 14 d afterwards. Physical performance was measured by the Timed Up and Go (TUG) test, and 10-m gait time was measured at comfortable and maximum speeds. They rated their knee or hip pain using a visual analog scale (VAS) for daily life activities. Psychological characteristics were measured by the Pain Catastrophizing Scale (PCS). Physical characteristics were measured by isometric muscle strength of knee extensors and hip abductors on the operated side. The variables of percent changes between pre- and post-operation were calculated by dividing post-operation score by pre-operation score.
RESULTS
Postoperative VAS and PCS were better than preoperative for both TKA and THA. Postoperative physical performance and muscle strength were poorer than preoperative for both TKA and THA. The percent change in physical performance showed no correlation with preoperative variables. In TKA patients, the percent change of PCS showed correlation with percent change of TUG ( = 0.016), 10-m gait time at comfortable speeds ( = 0.003), and 10-m gait time at maximum speeds ( = 0.042). The percent change of muscle strength showed partial correlation with physical performances. The percent change of VAS showed no correlation with physical performances. On the other hand, in THA patients, the percent change of hip abductor strength showed correlation with percent change of TUG ( = 0.047), 10-m gait time at comfortable speeds ( = 0.001), and 10-m gait time at maximum speeds ( = 0.021). The percent change of knee extensor strength showed partial correlation with physical performances. The percent change of VAS and PCS showed no correlation with physical performances.
CONCLUSION
Changes in pain catastrophizing significantly associated with changes in physical performance in the early period after TKA. It contributes to future postoperative rehabilitation of arthroplasty.
目的
探讨全膝关节置换术（TKA）或全髋关节置换术（THA）后早期疼痛灾难化程度的降低是否与身体功能相关。
方法
46名参与者的研究组接受了TKA或THA。在手术前7天内及术后14天对参与者进行评估。身体功能通过定时起立行走（TUG）测试进行测量，以舒适速度和最大速度测量10米步态时间。他们使用视觉模拟量表（VAS）对日常生活活动中的膝关节或髋关节疼痛进行评分。心理特征通过疼痛灾难化量表（PCS）进行测量。身体特征通过手术侧膝关节伸肌和髋关节外展肌的等长肌力进行测量。术前和术后变化百分比变量通过将术后得分除以术前得分来计算。
结果
TKA和THA术后的VAS和PCS均优于术前。TKA和THA术后的身体功能和肌肉力量均比术前差。身体功能的变化百分比与术前变量无相关性。在TKA患者中，PCS的变化百分比与TUG的变化百分比（=0.016）、舒适速度下的10米步态时间（=0.003）和最大速度下的10米步态时间（=0.042）相关。肌肉力量的变化百分比与身体功能呈部分相关。VAS的变化百分比与身体功能无相关性。另一方面，在THA患者中，髋关节外展肌力量的变化百分比与TUG的变化百分比（=0.047）、舒适速度下的10米步态时间（=0.001）和最大速度下的10米步态时间（=0.021）相关。膝关节伸肌力量的变化百分比与身体功能呈部分相关。VAS和PCS的变化百分比与身体功能无相关性。
结论
TKA后早期疼痛灾难化程度的变化与身体功能的变化显著相关。这有助于未来关节置换术后的康复。
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