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渐进式抗阻训练对早期术后快速通道全髋关节或膝关节置换术的影响:系统评价和荟萃分析。

Effects of progressive resistance training for early postoperative fast-track total hip or knee arthroplasty: A systematic review and meta-analysis.

机构信息

Department of Orthopedics and Sports Medicine and Joint Surgery, The People's Hospital of China Medical University, Shenyang, PR China.

Department of Orthopedics and Sports Medicine and Joint Surgery, The People's Hospital of China Medical University, Shenyang, PR China.

出版信息

Asian J Surg. 2021 Oct;44(10):1245-1253. doi: 10.1016/j.asjsur.2021.02.007. Epub 2021 Mar 11.

Abstract

Progressive resistance training (PRT) is one of the most commonly used exercise methods after joint replacement, while its effectiveness and safety are still controversial. Therefore, it's vital to investigate the effect of PRT on muscle strength and functional capacity early postoperative total hip arthroplasty (THA) or total knee arthroplasty (TKA). Relevant studies were identified via a search of Medline, Web of science and Cochrane Library from 2002 to 12 May 2020. Fifteen of 704 studies which comprised 6 THAs and 8 TKAs, involving 1021 adult patients were eligible for inclusion in the meta-analysis. There were no significant differences between the two groups after TKA in the 6-min walk test (6-WMT) within 1 month (95% CI = -0.41, 1.53), within 3 months (95% CI = -0.27, 0.76), within 12 months (95% CI = -0.29, 0.66); climb performance in seconds (s) (SCP), leg extension power, timed up and go test in seconds (s) (TUG) within 1 month (95% CI = -1.75, 0.77), within 3 months (95% CI = -0.48, 0.33), within 12 months (95% CI = -0.44, 0.35), sit to stand, number of repetitions in 30s (ST). There was no difference in the incidence of adverse events (95% CI = -0.01, 0.10). Similarly, two groups were also no obvious distinction after THA in the 6-WMT, SCP, Leg extension power, ST. PRT early after THA or TKA did not differ significantly from SR in terms of functional capacity, muscle strength recovery and incidence of adverse events. PRT is one of the options for rapid rehabilitation after joint replacement.

摘要

渐进式抗阻训练(PRT)是关节置换术后最常用的运动方法之一,但其效果和安全性仍存在争议。因此,研究 PRT 对全髋关节置换术(THA)或全膝关节置换术(TKA)后早期肌肉力量和功能能力的影响至关重要。通过对 Medline、Web of science 和 Cochrane Library 进行检索,我们于 2002 年至 2020 年 12 月 12 日找到了相关研究。纳入的 15 项研究中有 6 项 THA 和 8 项 TKA,涉及 1021 例成年患者,符合纳入标准。TKA 后 1 个月(95%CI=-0.41,1.53)、3 个月(95%CI=-0.27,0.76)、12 个月(95%CI=-0.29,0.66)内,两组在 6 分钟步行试验(6-WMT)中差异无统计学意义;1 个月内(95%CI=-1.75,0.77)、3 个月内(95%CI=-0.48,0.33)、12 个月内(95%CI=-0.44,0.35),两组在爬梯时间(s)(SCP)、伸膝力量、起立-行走计时测试(TUG)中差异无统计学意义;1 个月内(95%CI=-0.01,0.10),两组不良事件发生率差异无统计学意义。THA 后,两组在 6-WMT、SCP、伸膝力量、ST 方面也无明显差异。THA 或 TKA 后早期进行 PRT 在功能能力、肌肉力量恢复和不良事件发生率方面与 SR 无显著差异。PRT 是关节置换术后快速康复的选择之一。

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