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髋关节骨折术后患者进行髋关节外展肌低强度神经肌肉电刺激步态训练的效果:两例病例报告。

The effect of gait training with low-intensity neuromuscular electrical stimulation of hip abductor muscles in two patients following surgery for hip fracture: Two case reports.

机构信息

Department of Rehabilitation, Kawamura Hospital, Akutami, Japan.

Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan.

出版信息

Physiother Theory Pract. 2022 Oct;38(10):1553-1563. doi: 10.1080/09593985.2020.1864798. Epub 2020 Dec 23.

Abstract

BACKGROUND

The rate of force development (RFD) is an indicator of muscle strength. A previous study reported that the RFD of hip abductor muscles was increased by neuromuscular electrical stimulation (NMES) to gluteus medius (GM) during gait in healthy adults. However, the effects for patients following femoral head replacement for hip fracture are unclear.

PURPOSE

The aim of this case report was to investigate the effects of gait training with sub-motor threshold NMES on RFD of hip abductor muscles in two patients following femoral head replacement for hip fracture compared to gait training without NMES.

CASE DESCRIPTION

Two elderly patients following femoral head replacement for hip fracture received both interventions of gait training with sub-motor threshold NMES to GM and without NMES. Intervention phases involved 14 sessions each, for 28 sessions total.

OUTCOMES

The RFD of hip abductor muscles, maximum walking speed, six-minute walk distance (6MWD), Berg Balance Scale, one-leg standing time (OLST), functional independence measure, and Numeric Pain Rating Scale (NPRS) were used as outcome measures. In both patients, RFD, 6MWD, OLST, and NPRS were improved by gait training with NMES compared to without NMES.

CONCLUSION

Our results suggest the potential of NMES as a treatment methodology for these two patients undergoing femoral head replacement for hip fracture.

摘要

背景

力量发展速率(RFD)是肌肉力量的一个指标。先前的一项研究表明,在健康成年人行走过程中,通过神经肌肉电刺激(NMES)对臀中肌(GM)进行刺激,可以增加髋关节外展肌的 RFD。然而,对于髋关节骨折行股骨头置换术后的患者,其效果尚不清楚。

目的

本病例报告的目的是研究与不使用 NMES 的步态训练相比,针对髋关节骨折行股骨头置换术后的两名患者,使用亚运动阈 NMES 进行步态训练对髋关节外展肌 RFD 的影响。

病例描述

两名髋关节骨折行股骨头置换术后的老年患者均接受了亚运动阈 NMES 刺激 GM 与不使用 NMES 的两种步态训练干预。干预阶段各包含 14 次治疗,共 28 次治疗。

结果

髋关节外展肌的 RFD、最大步行速度、6 分钟步行距离(6MWD)、Berg 平衡量表、单腿站立时间(OLST)、功能独立性测量和数字疼痛评分量表(NPRS)均被用作评估结果。在这两名患者中,与不使用 NMES 的步态训练相比,NMES 刺激 GM 的步态训练均能提高 RFD、6MWD、OLST 和 NPRS。

结论

我们的研究结果表明,NMES 可能成为髋关节骨折行股骨头置换术后的这两名患者的一种治疗方法。

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