School of Allied Health, La Trobe University, Melbourne, Australia.
Physiotherapy Department, Eastern Health, Box Hill, Australia.
Clin Rheumatol. 2019 Mar;38(3):665-674. doi: 10.1007/s10067-018-4317-6. Epub 2018 Oct 3.
Usual care after hip or knee joint replacement does not adequately address the problem of low physical activity levels. We aimed to determine whether exercise delivered in a group setting in the early stage of outpatient rehabilitation influenced self-reported physical activity levels after hip or knee joint replacement. A case series of 79 participants referred to a 6-week outpatient orthopaedic exercise group after total hip or knee replacement were evaluated using the International Physical Activity Questionnaire (IPAQ) short form. Physical function was evaluated using Osteoarthritis Research Society International (OARSI) recommended performance-based tests (30 s Chair Stand Test, 40 m Fast Pace Walk Test, Stair Climb Test, Timed Up and Go Test, 6 Minute Walk Test). Measures were assessed at admission, discharge and 6 weeks after group discharge. Non-parametric analysis was conducted for IPAQ scores. Analysis of functional measures was conducted with linear mixed models with time modelled as a repeated measure. Standard multiple regression and correlation analysis were conducted. Fifty-four participants completed the study. Self-reported activity levels improved significantly at program discharge but not at 6-week follow-up. All performance-based measures improved significantly at program discharge. Fast-paced walking and 6 Minute Walk Test measures continued to improve at 6-week follow-up. Group dynamics present in an outpatient rehabilitation exercise program may increase physical activity levels during group participation but not after group cessation. Performance in all functional measures improved at group discharge.
常规的髋关节或膝关节置换术后护理并不能充分解决低身体活动水平的问题。我们旨在确定在门诊康复的早期阶段以小组形式进行的运动是否会影响髋关节或膝关节置换术后的自我报告身体活动水平。对 79 名接受全髋关节或膝关节置换术后 6 周门诊骨科运动小组治疗的患者进行了病例系列研究，使用国际体力活动问卷（IPAQ）短表进行评估。使用骨关节炎研究协会国际（OARSI）推荐的基于表现的测试（30 秒椅子站立测试、40 米快速步伐行走测试、楼梯爬升测试、起立和行走测试、6 分钟步行测试）评估身体功能。在入院时、出院时和小组出院后 6 周评估测量值。对 IPAQ 评分进行非参数分析。使用线性混合模型对功能测量进行分析，时间作为重复测量进行建模。进行了标准多元回归和相关分析。54 名参与者完成了研究。在出院时，自我报告的活动水平显著提高，但在 6 周随访时没有提高。所有基于表现的测量在出院时均显著改善。快速步行和 6 分钟步行测试的测量值在 6 周随访时仍在继续改善。门诊康复运动计划中存在的小组动态可能会增加小组参与期间的身体活动水平，但不会在小组停止后增加。所有功能测量的表现均在出院时改善。
