Orthopedics and Sports Medicine Center, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu Province, 215008, China.
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, 999077, China.
BMC Musculoskelet Disord. 2023 Oct 14;24(1):817. doi: 10.1186/s12891-023-06806-y.
Exercise rehabilitation training is an important measure for improving the prognosis of patients with hip fractures. However, the particular program that works effectively and the efficiency of exercise therapy are still controversial.
To compare the effects of usual postoperative care combined with rehabilitation based on exercise prescription on motor function and complications in elderly patients who underwent surgery for hip fracture.
This was an observational study. A total of 71 elderly patients with hip fractures who were treated with hip arthroplasty and internal fixation of the proximal femur with an intramedullary nail at Suzhou Municipal Hospital from October 2020 to December 2021 were included; 11 cases were excluded (eight cases were excluded due to loss of follow-up, two due to deaths from other causes, and one due to other reasons). Finally, 60 patients (18 males and 42 females) were included. Patients were randomly assigned to the control (n = 30) and experimental (n = 30) groups using a random number generator. Patients in the control group received usual postoperative care, whereas those in the experimental group received usual postoperative care combined with rehabilitation training based on the principles of exercise prescription. We recorded the motor function (Harris hip score), daily living ability (Barthel Index), and complications at discharge and 1, 3, and 6 months postoperatively for statistical analysis.
The Harris hip score and Barthel Index score were significantly higher at 1, 3, and 6 months postoperatively than at discharge in both groups (p < 0.05). The Harris hip score and Barthel Index score at discharge and 1, 3, and 6 months postoperatively were significantly higher in the experimental group than in the control group (p < 0.05). The incidence of complications at 6 months postoperatively was significantly lower in the experimental group than in the control group (13% vs. 37%).
Rehabilitation therapy based on exercise prescription helps improve hip function and the ability to perform activities of daily living and related postoperative complications after hip fracture surgery in elderly patients. The findings of our study will guide decision-making in clinical practice and improve the clinical management of hip fractures in elderly patients postoperatively.
运动康复训练是改善髋部骨折患者预后的重要措施。然而,何种特定的方案最有效以及运动疗法的效率仍存在争议。
比较常规术后护理联合基于运动处方的康复治疗对接受髋关节骨折手术治疗的老年患者运动功能和并发症的影响。
这是一项观察性研究。纳入 2020 年 10 月至 2021 年 12 月在苏州市立医院接受髋关节置换术和股骨近端髓内钉内固定术的 71 例髋部骨折老年患者;排除 11 例(8 例失访,2 例因其他原因死亡,1 例因其他原因退出)。最终纳入 60 例患者(男 18 例,女 42 例)。采用随机数字发生器将患者随机分为对照组(n=30)和实验组(n=30)。对照组患者接受常规术后护理,实验组患者在常规术后护理的基础上接受基于运动处方原则的康复训练。记录患者术后出院时及 1、3、6 个月的运动功能(Harris 髋关节评分)、日常生活能力(Barthel 指数)和并发症。
两组患者出院时及术后 1、3、6 个月的 Harris 髋关节评分和 Barthel 指数评分均明显高于出院时(p<0.05),实验组患者出院时及术后 1、3、6 个月的 Harris 髋关节评分和 Barthel 指数评分均明显高于对照组(p<0.05)。实验组患者术后 6 个月的并发症发生率明显低于对照组(13%比 37%)。
基于运动处方的康复治疗有助于改善老年髋部骨折患者术后髋关节功能和日常生活活动能力,并降低相关术后并发症的发生率。本研究结果将为临床实践提供决策指导,改善老年髋部骨折患者术后的临床管理。