Harikesavan Karvannan, Chakravarty Raj D, Maiya Arun G, Hegde Sanjay P, Y Shivanna Shivakumar
Department of Physiotherapy, School of Allied Health sciences, Manipal University, Bangalore. India.
Orthopaedic joint replacement surgeon. Manipal Hospital, Bangalore. India.
Open Rheumatol J. 2017 Mar 31;11:30-42. doi: 10.2174/1874312901711010030. eCollection 2017.
Total knee replacement (TKR) is the commonest surgical procedure for patients with severe pain and impaired physical function following end stage knee osteoarthritis. The hip abductors are well renowned in stabilization of the trunk and hip during walking, maintaining the lower limb position, and transferring the forces from the lower limbs to the pelvis.
To assess the efficacy of hip abductor strengthening exercise on functional outcome using performance based outcome measures following total knee replacement.
An observer blinded randomized pilot trial design was conducted at Manipal hospital, Bangalore, India. Participants designated for elective TKR were randomized to experimental group hip abductor strengthening along with standard rehabilitation (n=10) or control group standard rehabilitation alone (n=10). Participants followed for one year to assess physical function using performance based outcomes, such as timed up and go test, single leg stance test, six minute walk test, knee extensor strength and hip abductor strength.
Eighteen participants with a mean age of 63.1 ± 5.5 years (8 Males and 10 Females) completed the study. Improvement in hip abduction strength, single leg stand test was superior in hip abductor strengthening group at 3 months and 1 year when compared to standard rehabilitation alone.
Hip abductor strengthening showed superior improvements in single leg stance test and six minute walk test. Hip abductor strengthening exercises has the potential to improve physical function following total knee replacement.
全膝关节置换术（TKR）是终末期膝关节骨关节炎患者出现严重疼痛和身体功能受损时最常见的外科手术。髋外展肌在行走过程中对躯干和髋关节的稳定、维持下肢位置以及将下肢力量传递至骨盆方面具有重要作用。
使用基于表现的结局指标评估全膝关节置换术后髋外展肌强化训练对功能结局的疗效。
在印度班加罗尔的马尼帕尔医院进行了一项观察者盲法随机试点试验设计。计划进行择期全膝关节置换术的参与者被随机分为实验组（进行髋外展肌强化训练并接受标准康复治疗，n = 10）或对照组（仅接受标准康复治疗，n = 10）。对参与者进行为期一年的随访，使用基于表现的结局指标评估身体功能，如计时起立行走测试、单腿站立测试、六分钟步行测试、膝关节伸肌力量和髋外展肌力量。
18名平均年龄为63.1±5.5岁的参与者（8名男性和10名女性）完成了研究。与仅接受标准康复治疗相比，髋外展肌强化训练组在3个月和1年时髋外展肌力量及单腿站立测试的改善更为显著。
髋外展肌强化训练在单腿站立测试和六分钟步行测试中显示出更显著的改善。髋外展肌强化训练有可能改善全膝关节置换术后的身体功能。
