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全髋关节置换术前进行渐进性抗阻训练的效果——一项随机对照试验的二次分析

Effects of progressive resistance training prior to total HIP arthroplasty - a secondary analysis of a randomized controlled trial.

作者信息

Holsgaard-Larsen A, Hermann A, Zerahn B, Mejdahl S, Overgaard S

机构信息

Orthopedic Research Unit, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Denmark; Department of Clinical Research, University of Southern Denmark, Denmark.

Orthopedic Research Unit, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Denmark; Department of Clinical Research, University of Southern Denmark, Denmark; Department of Orthopedic Surgery, Herlev University Hospital, Denmark.

出版信息

Osteoarthritis Cartilage. 2020 Aug;28(8):1038-1045. doi: 10.1016/j.joca.2020.04.010. Epub 2020 May 4.

Abstract

OBJECTIVE

To investigate 1-year postoperative effect of preoperative resistance training (RT) in patients undergoing total hip arthroplasty (THA) on patient-reported outcomes on activity and function and objective outcomes on muscle strength and physical performance.

DESIGN

A 3-12 months follow-up of a randomized controlled trial. Patients scheduled for THA were randomized into: RT-group, twice a week for 10 weeks prior to THA, or 'care-as-usual' (CG). Primary endpoint of this sequel analysis is HOOS-ADL at 12 months follow-up. Secondary outcome measures are; other HOOS subscales, knee- and hip muscle strength plus function (gait, ascending/descending stairs, and sit-to-stand) at three and/or 12 months. CLINICALTRIALS.GOV: NCT01164111.

RESULTS

Eighty patients (70% women, 70.4 ± 7.6 years, BMI of 27.8 ± 4.6) were randomized to RT (n = 40) or CG (n = 40); data from 85% were available at 12 months. No superior effects were observed at 12 months for HOOS ADL (between-group change score [95%CI]) (2.6 [-4.2; 9.8], P = 0.44) or remaining subscales. However, ascending (1.3 s [0.3; 2.3], P = 0.01)) and descending stairs (1.6 s [0.3; 2.9], P = 0.01) demonstrated additional effects. At 3 months clinically relevant change-scores in favour of RT was observed on HOOS-Sport/Rec (10.5 points [1.4; 19.6], P = 0.023), together with higher knee strength of the affected side (14.6 Nm [6.3; 22.9], P < 0.001), and selected outcomes of physical function.

CONCLUSIONS

At 12 months after surgery, there was no additional effect of preoperative RT compared with THA alone, but rehabilitation was accelerated at 3 months.

摘要

目的

研究全髋关节置换术(THA)患者术前进行阻力训练(RT)对术后1年患者报告的活动和功能结局以及肌肉力量和身体表现的客观结局的影响。

设计

一项随机对照试验的3 - 12个月随访。计划接受THA的患者被随机分为:RT组,在THA前每周两次,共10周,或“常规护理”(CG)组。本次后续分析的主要终点是12个月随访时的HOOS - ADL。次要结局指标包括:其他HOOS子量表、3个月和/或12个月时的膝关节和髋关节肌肉力量及功能(步态、上下楼梯和从坐到站)。临床试验注册编号:NCT01164111。

结果

80例患者(70%为女性,年龄70.4±7.6岁,体重指数27.8±4.6)被随机分为RT组(n = 40)或CG组(n = 40);12个月时85%的数据可用。12个月时,HOOS - ADL(组间变化评分[95%置信区间])(2.6[-4.2;9.8],P = 0.44)或其余子量表未观察到显著优势。然而,上楼梯(1.3秒[0.3;2.3],P = 0.01)和下楼梯(1.6秒[0.3;2.9],P = 0.01)显示出额外的效果。在3个月时,观察到HOOS - 运动/娱乐方面有利于RT的临床相关变化评分(10.5分[1.4;19.6],P = 0.023),同时患侧膝关节力量更高(14.6牛米[6.3;22.9],P < 0.001),以及身体功能的选定结局。

结论

术后12个月,与单纯THA相比,术前RT没有额外效果,但在3个月时康复进程加快。

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