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平衡专项训练如何有助于改善髋部骨折后康复的老年受试者的身体功能:一项随机对照试验。

How balance task-specific training contributes to improving physical function in older subjects undergoing rehabilitation following hip fracture: a randomized controlled trial.

机构信息

1 Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.

2 Physical Medicine and Rehabilitation Unit, Scientific Institute of Lissone, Clinical and Scientific Institutes Maugeri, Institute of Care and Research (IRCCS), Lissone, Italy.

出版信息

Clin Rehabil. 2018 Mar;32(3):340-351. doi: 10.1177/0269215517724851. Epub 2017 Aug 14.

DOI:10.1177/0269215517724851
PMID:28805094
Abstract

OBJECTIVE

To evaluate the efficacy of a rehabilitation programme including balance task-specific training in improving physical function, pain, activities of daily living (ADL), balance and quality of life in subjects after a hip fracture.

DESIGN

Randomized controlled trial.

SUBJECTS

A total of 52 older subjects selected for internal fixation due to extra-capsular hip fracture were randomized to be included in an experimental ( n = 26) and control group ( n = 26).

INTERVENTIONS

The experimental group underwent a rehabilitation programme based on balance task-specific training. The control group underwent general physiotherapy, including open kinetic chain exercises and walking training. Both groups individually followed programmes of 90-minute sessions five times/week for three weeks.

OUTCOME MEASURES

The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), a Pain Numerical Rating Scale, the Berg Balance Scale, the Functional Independence Measure and the 36-item Short-Form Health Survey. The participants were evaluated before and after training, and after 12 months.

RESULTS

Significant effects of time, group and time × group were found for all outcome measures in favour of the experimental group. A clinically important between-group difference of 25 points was achieved after training and at follow-up in terms of the primary outcome (WOMAC function before treatment, after treatment and at follow-up was 84.8 (3.7), 39.8 (4.9) and 35.7 (6.2) for the experimental group and 80.9 (5.7), 65.2 (7.1) and 61.0 (11.1) for the control group).

CONCLUSION

An inpatient rehabilitation programme based on balance task-specific training is useful in improving physical function, pain, ADL and quality of life in older patients after hip fracture.

摘要

目的

评估包括平衡任务特异性训练的康复方案对改善髋关节骨折后患者的身体功能、疼痛、日常生活活动能力(ADL)、平衡和生活质量的疗效。

设计

随机对照试验。

受试者

共 52 名因囊外髋关节骨折选择内固定的老年患者,随机分为实验组(n=26)和对照组(n=26)。

干预

实验组接受基于平衡任务特异性训练的康复方案。对照组接受常规物理治疗,包括开链运动和步行训练。两组患者分别接受每周 5 次、每次 90 分钟的个人方案,共 3 周。

结果

所有结果测量指标(WOMAC、疼痛数字评分量表、Berg 平衡量表、功能独立性测量和 36 项简明健康调查)的时间、组和时间×组的影响均有统计学意义,实验组的结果均有改善。治疗后和随访时,实验组在主要结局(WOMAC 功能评分治疗前、治疗后和随访时分别为 84.8(3.7)、39.8(4.9)和 35.7(6.2),对照组为 80.9(5.7)、65.2(7.1)和 61.0(11.1))方面取得了 25 分的临床重要组间差异。

结论

基于平衡任务特异性训练的住院康复方案有助于改善髋关节骨折后老年患者的身体功能、疼痛、ADL 和生活质量。

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