Matheis Clarissa, Stöggl Thomas
Sana-Kliniken Solln/Sendling, Munich, Germany.
Dept. of Sport Science and Kinesiology, Universität Salzburg, Hallein/Rif, Austria.
J Bodyw Mov Ther. 2018 Apr;22(2):519-527. doi: 10.1016/j.jbmt.2017.06.012. Epub 2017 Jun 23.
Randomized controlled trial.
To improve hip function by an additional targeted mobilization and strength training of the hip muscles within the first postoperative week following a total hip arthroplasty (THA) in contrast to standard physiotherapy.
The aim of early postoperative physiotherapy is to improve the functioning of the artificial hip joint as well as the restoration of mobility and independence of the patient. Minimally invasive surgical techniques allow early mobilization with immediate full weight-bearing.
39 patients were divided into an intervention (IG) and control group (CG). After implantation of THA the CG completed standard physiotherapy, while the IG had an intensified active treatment with additional mobilization and strength training. Passive range of motion (flexion, extension, abduction), thigh circumference, holding force of the gluteal muscles, one-leg stance, covered distance walked in 6-min and subjective parameters were tested one day before and six days after surgery.
Improvements in IG compared to CG were recorded in range of motion (flexion p < 0.01, extension p < 0.001, abduction p < 0.01) and gait performance (p < 0.001). No differences between groups were detected as regard thigh circumference, holding force of the gluteal muscles, one-leg stance and subjective parameters. Deterioration in IG compared to CG did not occur.
An additional, targeted mobilization and strength training of the hip muscles with full weight-bearing, which begins at the 3rd day after implantation of a THA is tolerated well and improves within one week hip range of motion and gait performance compared to standard physiotherapy.
随机对照试验。
与标准物理治疗相比,在全髋关节置换术(THA)术后第一周内,通过对髋部肌肉进行额外的针对性活动和力量训练来改善髋关节功能。
术后早期物理治疗的目的是改善人工髋关节的功能以及患者活动能力和独立性的恢复。微创外科技术允许早期活动并立即完全负重。
39例患者被分为干预组(IG)和对照组(CG)。THA植入后,CG完成标准物理治疗,而IG进行强化主动治疗,包括额外的活动和力量训练。在手术前一天和术后六天测试被动活动范围(屈曲、伸展、外展)、大腿围度、臀肌握力、单腿站立、6分钟步行距离以及主观参数。
与CG相比,IG在活动范围(屈曲p<0.01,伸展p<0.001,外展p<0.01)和步态表现(p<0.001)方面有改善。在大腿围度、臀肌握力、单腿站立和主观参数方面,两组之间未检测到差异。与CG相比,IG未出现恶化情况。
在THA植入后第3天开始进行额外的、针对髋部肌肉的负重活动和力量训练,耐受性良好,与标准物理治疗相比,在一周内可改善髋关节活动范围和步态表现。