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髋关节周围软组织松解术联合再排列运动治疗 Harris 髋关节评分<60 分的髋关节炎患者的疗效

Effects of pericapsular soft tissue and realignment exercises for patients with osteoarthritis of the hip and Harris Hip Score below 60 points.

机构信息

Arthritis Center, Fukuoka Wajiro Hospital, Fukuoka, Japan.

Department of Orthopaedic Surgery, Asama General Hospital, Nagano, Japan.

出版信息

Curr Med Res Opin. 2022 Sep;38(9):1567-1578. doi: 10.1080/03007995.2022.2088716. Epub 2022 Jul 21.

Abstract

OBJECTIVE

To investigate the effectiveness of pericapsular soft tissue and realignment (PSTR) exercises for patients with osteoarthritis (OA) of the hip and Harris Hip Score (HHS) below 60 points. Most previous studies of hip exercise have not been applied for patients with moderate to severe hip OA, especially those with an HHS below 60 points. Most studies of hip exercise in OA have involved muscle strength training, stretching, functional training and aerobic fitness programs, and have not included pelvic realignment exercise. We investigated the effect of pelvic realignment exercise for patients with hip OA and HHS below 60 points.

METHODS

Design: multicenter, prospective, observational, single-arm study. Setting: clinical examination on an outpatient basis. Participants: 193 patients with hip OA and HHS below 60 points. Interventions: patient education and supervised PSTR exercises. Outcome measures: primary outcome: HHS; secondary outcomes: changes in numerical rating scale (NRS) scores, abduction of range of motion, Timed Up and Go (TUG) test within 30 min after PSTR exercises at baseline and other six items, full analysis set (FAS, all participants who performed PSTR exercises) and subgroup analysis (participants with minimal joint space (MJS) of 0 mm at baseline).

RESULTS

FAS analysis ( = 193): significant differences in HHS were found between baseline and 3 month follow-up, and between baseline and 6 month follow-up in the Unilateral and Bilateral OA groups ( < .001). All mean differences were within the 95% confidence interval. Significant improvement in NRS scores, abduction of range of motion, and TUG test within 30 min after PSTR exercises were found at baseline ( < .001). Subgroup analysis ( = 130): the results revealed significant differences ( < .001) in HHS and NRS, abduction of range of motion and TUG test within 30 min after PSTR exercises at baseline, as in the FAS analysis.

CONCLUSION

Our findings suggested that PSTR exercises were effective for patients with HHS below 60 points, even those with MJS of 0 mm.

CLINICAL TRIALS REGISTRY

20 July 2017 (UMIN000028277).

摘要

目的

探讨囊周软组织和重新排列(PSTR)运动治疗髋关节骨关节炎(OA)和 Harris 髋关节评分(HHS)低于 60 分患者的疗效。既往大多数髋关节运动研究未应用于中重度髋关节 OA 患者,尤其是 HHS 低于 60 分的患者。大多数髋关节 OA 运动研究涉及肌肉力量训练、伸展、功能训练和有氧运动方案,未包括骨盆重新排列运动。我们研究了骨盆重新排列运动对 HHS 低于 60 分的髋关节 OA 患者的影响。

方法

设计:多中心、前瞻性、观察性、单臂研究。设置:门诊临床检查。参与者:193 例 HHS 低于 60 分的髋关节 OA 患者。干预措施:患者教育和监督 PSTR 运动。观察指标:主要结局:HHS;次要结局:数字评分量表(NRS)评分变化、运动范围外展、PSTR 运动后 30 分钟内 Timed Up and Go(TUG)试验,基线及其他 6 项,全分析集(FAS,所有进行 PSTR 运动的参与者)和亚组分析(基线最小关节间隙(MJS)为 0mm 的参与者)。

结果

FAS 分析(n=193):单侧和双侧 OA 组 HHS 在基线和 3 个月随访时、基线和 6 个月随访时差异均有统计学意义(均<.001)。所有平均差值均在 95%置信区间内。PSTR 运动后 30 分钟内 NRS 评分、运动范围外展和 TUG 试验均有显著改善(均<.001)。亚组分析(n=130):结果显示,在基线时,HHS 和 NRS、运动范围外展和 TUG 试验在 PSTR 运动后 30 分钟内的差异均有统计学意义(均<.001),与 FAS 分析结果一致。

结论

我们的研究结果表明,PSTR 运动对 HHS 低于 60 分的患者,甚至 MJS 为 0mm 的患者均有效。

临床试验注册

2017 年 7 月 20 日(UMIN000028277)。

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