Engdal Monika, Foss Olav A, Taraldsen Kristin, Husby Vigdis S, Winther Siri B
From the Department of Physiotherapy, Clinic of Clinical Services (ME), and Orthopedic Research Center, Orthopedic Department (OAF, SBW), Trondheim University Hospital; and Department of Neuroscience, Faculty of Medicine, NTNU (KT, SBW), and Faculty of Nursing Science (VSH), Norwegian University of Science and Technology, Trondheim, Norway. From the Orthopedic Research Center, Orthopedic Department, and Department of Physiotherapy, Clinic of Clinical Services, Trondheim University Hospital, Trondheim, Norway.
Am J Phys Med Rehabil. 2017 Jul;96(7):473-478. doi: 10.1097/PHM.0000000000000657.
Muscle weakness due to trauma from the surgical approach is anticipated to affect the ability of the patient to undertake daily physical activity early after total hip arthroplasty (THA). The objective of this study was to compare daily physical activity on days 1 to 4 after discharge, in patients following THA performed by 1 of 3 surgical approaches.
A cohort study included 60 hip osteoarthritis patients, scheduled for THA, allocated to direct lateral approach, posterior approach, or anterior approach. Daily physical activity was measured by an accelerometer, with upright time per 24 hours as primary outcome and walking time, number of steps, and number of upright events per 24 hours as secondary outcomes.
There were no statistically significant group differences in any of the measures of daily physical activity (P > 0.290) or between days of follow-up (P > 0.155). Overall, the median participant had 3.50 hours (interquartile range, 2.85-4.81 hours) of upright time, and participants showed wide variation in all outcomes of daily physical activity.
There were no differences in daily physical activity between THA patients undergoing different surgical approaches. The surgical approach may not be a limiting factor for daily physical activity early after surgery in a fast-track treatment course.
预计全髋关节置换术(THA)后早期,手术入路造成的创伤导致的肌肉无力会影响患者进行日常体力活动的能力。本研究的目的是比较采用三种手术入路之一进行THA的患者出院后第1至4天的日常体力活动情况。
一项队列研究纳入了60例计划进行THA的髋骨关节炎患者,分为直接外侧入路、后入路或前入路。通过加速度计测量日常体力活动,以每24小时的直立时间作为主要结局,每24小时的步行时间、步数和直立事件数作为次要结局。
在日常体力活动的任何测量指标上,各组之间均无统计学显著差异(P>0.290),随访各天之间也无差异(P>0.155)。总体而言,参与者的中位直立时间为3.50小时(四分位间距,2.85 - 4.81小时),并且参与者在日常体力活动的所有结局方面表现出很大差异。
接受不同手术入路的THA患者在日常体力活动方面没有差异。在快速康复治疗过程中,手术入路可能不是术后早期日常体力活动的限制因素。