Baek Junghyun, Park Nohkyoung, Lee Bongju, Jee Sungju, Yang Shinseung, Kang Sangkuk
Department of Physical Medicine and Rehabilitation, Sun General Hospital, Daejeon, Korea.
Department of Orthopedic Surgery, Sun General Hospital, Daejeon, Korea.
Ann Rehabil Med. 2018 Feb;42(1):67-75. doi: 10.5535/arm.2018.42.1.67. Epub 2018 Feb 28.
To investigate the effects of repetitive peripheral magnetic stimulation (rPMS) on the vastus lateralis (VL) in the early stage after hip replacement surgery.
Twenty-two patients who underwent hip replacement after proximal femur fracture were included in this study. After hip surgery, the experimental group was applied with 15 sessions of 10 Hz rPMS over the VL 5 times per week for 3 weeks, while the control group took sham stimulation. All patients were also given conventional physical therapy. The VL strength was measured with the root mean square (RMS) value of the VL with surface electromyography technique. The ratio of RMS values between fractured and unfractured legs and tandem stand test were used to assess standing balance. Usual gait speed was measured to evaluate gait function. Pain in two groups was assessed with visual analog scale (VAS).
Both RMS value of the VL and the ratio of RMS values after rPMS were significantly improved (p<0.05). Also, tandem standing time and usual gait speed in rPMS group were dramatically increased (p<0.05). However, no significant difference in VAS was found between the two groups after 3 weeks.
rPMS on the VL improved muscle strength, standing balance and gait function in the early stage after hip surgery. Therefore, rPMS could be applied to patients who cannot take electrical stimulation due to pain and an unhealed wound.
探讨重复经外周磁刺激(rPMS)对髋关节置换术后早期股外侧肌(VL)的影响。
本研究纳入22例股骨近端骨折后行髋关节置换术的患者。髋关节手术后,实验组每周5次,共15次,对VL施加10Hz的rPMS,持续3周,而对照组进行假刺激。所有患者均接受常规物理治疗。采用表面肌电图技术,通过股外侧肌的均方根(RMS)值测量股外侧肌力量。采用骨折侧与未骨折侧RMS值之比及串联站立试验评估站立平衡。测量日常步态速度以评估步态功能。采用视觉模拟评分法(VAS)评估两组患者的疼痛情况。
rPMS后股外侧肌的RMS值及其比值均显著改善(p<0.05)。此外,rPMS组的串联站立时间和日常步态速度显著增加(p<0.05)。然而,3周后两组间VAS无显著差异。
对股外侧肌进行rPMS可改善髋关节置换术后早期的肌肉力量、站立平衡和步态功能。因此,rPMS可应用于因疼痛和伤口未愈合而无法接受电刺激的患者。