Department of Orthopaedics, Tianjin Hospital, Tianjin, China.
Department of Hip Trauma, Tianjin Hospital, Tianjin, China.
Orthop Surg. 2023 Feb;15(2):423-431. doi: 10.1111/os.13521. Epub 2022 Nov 29.
OBJECTIVE: To compare the effectiveness of a six-month home-based telerehabilitation based on the Internet-based rehabilitation management system coupled with conventional outpatient care in elderly patients with hip fractures following total hip replacement (THR). METHODS: Elderly patients (aged over 65 years) with first hip fractures who underwent THR between March 2018 and September 2018 in Tianjin Hospital were enrolled in this study. Patients were divided into two groups: telerehabilitation group (n = 43) and telephone group (n = 42). A Internet-based telerehabilitation management system was established and applied on patients in the telerehabilitation group. For patients in the telephone group, the rehabilitation intervention was administered through conventional outpatient care (telephone along with outpatient follow-up). Data from the Harris hip scale (HHS), functional independence measure (FIM), self-rating anxiety scale (SAS), and postoperative complications at 1, 3, and 6 months after surgery were collected and compared between the two groups. RESULTS: A total of 85 elderly patients completed the 6-month follow-up assessment. Results showed that the HHS score was significantly higher in the telerehabilitation group than in the telephone group at 1 month (66.35 ± 4.63 vs 63.48 ± 4.49), 3 months (76.33 ± 4.52 vs 71.81 ± 3.84), and 6 months (84.23 ± 3.13 vs 77.29 ± 4.95) after surgery (P < 0.001). The FIM score was significantly higher in the telerehabilitation group than in the telephone group at 1 month (89.00 ± 5.63 vs 73.35 ± 8.70), 3 months (100.16 ± 4.56 vs 92.81 ± 5.17), and 6 months (111.70 ± 3.13 vs 98.64 ± 5.12) after surgery (P < 0.001). The SAS score was significantly lower in the telerehabilitation group than in the telephone group at 1 month (42.40 ± 3.07 vs 46.21 ± 3.53), 3 months (36.77 ± 2.26 vs 40.24 ± 1.66), and 6 months (29.26 ± 1.63 vs 33.81 ± 2.62) after surgery (P < 0.001). The overall complication rate was significantly lower in the telerehabilitation group than in the telephone group (14% vs 40.5%) (P < 0.05). CONCLUSION: Internet-based rehabilitation management system can not only promote the physical rehabilitation of patients, but also play a positive role in psychological rehabilitation and the prevention of complications, which provides new ideas and methods for clinical rehabilitation.
目的：比较基于互联网康复管理系统的六个月家庭远程康复与传统门诊康复相结合对全髋关节置换术后老年髋部骨折患者的疗效。
方法：本研究纳入 2018 年 3 月至 2018 年 9 月在天津市医院接受初次髋部骨折全髋关节置换术的 65 岁以上老年患者。将患者分为远程康复组（n=43）和电话组（n=42）。为远程康复组患者建立基于互联网的远程康复管理系统。对于电话组的患者，通过常规门诊护理（电话和门诊随访）进行康复干预。收集并比较两组患者术后 1、3、6 个月的 Harris 髋关节评分（HHS）、功能独立性测量（FIM）、焦虑自评量表（SAS）和术后并发症数据。
结果：共有 85 名老年患者完成了 6 个月的随访评估。结果显示，术后 1 个月（66.35±4.63 比 63.48±4.49）、3 个月（76.33±4.52 比 71.81±3.84）和 6 个月（84.23±3.13 比 77.29±4.95），远程康复组的 HHS 评分明显高于电话组（P<0.001）。术后 1 个月（89.00±5.63 比 73.35±8.70）、3 个月（100.16±4.56 比 92.81±5.17）和 6 个月（111.70±3.13 比 98.64±5.12），远程康复组的 FIM 评分明显高于电话组（P<0.001）。术后 1 个月（42.40±3.07 比 46.21±3.53）、3 个月（36.77±2.26 比 40.24±1.66）和 6 个月（29.26±1.63 比 33.81±2.62），远程康复组的 SAS 评分明显低于电话组（P<0.001）。术后 6 个月，远程康复组的总并发症发生率明显低于电话组（14%比 40.5%）（P<0.05）。
结论：基于互联网的康复管理系统不仅能促进患者的身体康复，而且对心理康复和并发症的预防也有积极作用，为临床康复提供了新的思路和方法。
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