Pozzi Federico, Madara Kathleen, Zeni Joseph A
University of Southern California, Los Angeles, CA, USA.
University of Delaware, Newark, DE, USA.
Int J Sports Phys Ther. 2017 Apr;12(2):259-272.
Most rehabilitation interventions after total hip arthroplasty (THA) are not designed to return patients to high-levels of physical activity and, thus, low levels of physical activity and residual weakness are common. The purpose of this case series was to describe the feasibility and preliminary efficacy of an exercise and education intervention for patients after THA who have already completed formal outpatient physical therapy.
Case series.
Two participants underwent unilateral THA seven (case A) or eight (case B) months prior to the intervention. Individuals participated in 18 treatment sessions that included progressive aerobic and strengthening exercises and meetings with a health coach. Change in function, strength, and self-reported physical activity were measured. Outcomes 12 months after surgery were compared to a historical cohort of patients after THA.
There were no adverse events during the intervention. At the end of the intervention, hip and knee strength on the surgical side increased approximately 30% compared to baseline in both cases. Activity level, and recreational performance, including walking up stairs and hiking uphill (case A), and running and golfing (case B), improved by the end of the intervention. Most changes were maintained at follow-up, although hip strength for case B decreased 27% after discharge from the intervention. Outcomes for both cases exceeded historical averages for patients 12 months after THA, with the exception of strength in case B.
The exercise intervention was well tolerated and without negative effects in two participants. Both participants increased their ability to complete demanding recreational and sports-related activities, physical activity, and demonstrated improved hip abductor and knee extensor strength. Further research is needed to evaluate the implementation and effectiveness of similar interventions after THA.
Level 4.
全髋关节置换术（THA）后的大多数康复干预措施并非旨在使患者恢复高水平的身体活动，因此，身体活动水平低和残留无力的情况很常见。本病例系列的目的是描述针对已完成正规门诊物理治疗的THA术后患者进行运动与教育干预的可行性和初步疗效。
病例系列。
两名参与者在干预前7个月（病例A）或8个月（病例B）接受了单侧THA。个体参加了18次治疗课程，包括渐进性有氧运动和强化运动以及与健康教练的会面。测量了功能、力量和自我报告的身体活动的变化。将术后12个月的结果与THA术后患者的历史队列进行比较。
干预期间未发生不良事件。在干预结束时，两个病例手术侧的髋部和膝部力量与基线相比均增加了约30%。干预结束时，活动水平以及娱乐表现得到改善，包括上楼梯和上坡徒步（病例A）以及跑步和打高尔夫球（病例B）。尽管病例B在干预出院后髋部力量下降了27%，但大多数变化在随访时得以维持。两个病例的结果均超过了THA术后12个月患者的历史平均水平，但病例B的力量除外。
运动干预在两名参与者中耐受性良好且无负面影响。两名参与者都提高了完成要求较高的娱乐和体育相关活动、身体活动的能力，并表现出髋外展肌和膝伸肌力量的改善。需要进一步研究来评估THA后类似干预措施的实施情况和有效性。
4级。
