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基于动静互补平衡理论的功能锻炼联合阶段性康复训练改善全髋关节置换术后患者髋关节功能恢复情况

[Dynamic and Static Complementary Balance Theory-Based Functional Exercise Combined With Stepwise Rehabilitation Training Improves Postoperative Hip Function Recovery in Patients Undergoing Total Hip Replacement].

作者信息

Xu Delong, Han Hong, Zuo Wei, Feng Zhiyong

机构信息

( 430000) Department of Rehabilitation Medicine, Wuhan Fourth Hospital, Wuhan 430000, China.

出版信息

Sichuan Da Xue Xue Bao Yi Xue Ban. 2024 Jul 20;55(4):1014-1019. doi: 10.12182/20240760603.

Abstract

OBJECTIVE

To analyze the application value of dynamic and static complementary balance theory-based functional exercise combined with stepwise rehabilitation training in postoperative hip function recovery in patients undergoing total hip replacement (THR).

METHODS

The clinical data of 118 inpatients undergoing THR between June 2022 and June 2023 were retrospectively collected. Among the patients, 57 were given perioperative stepwise rehabilitation training (the control group), and 61 were given a combination of functional exercise based on static and dynamic complementary balance theory and stepwise rehabilitation training during the perioperative period (the combination group). The postoperative recovery status and the incidence of postoperative complications in the two groups were recorded. During postoperative recovery, the patients were assessed for pain with the visual analogue scale (VAS) and for self-efficacy with the Self-Efficacy for Rehabilitation Outcome Scale (SER). Hip function was measured and compared between the two groups at 2 weeks, 4 weeks and 8 weeks after surgery.

RESULTS

With regard to the primary outcome indicator, the postoperative length-of-stay was (7.63±1.36) d in the combination group, which was shorter than the (8.22±1.48) d in the control group, and the difference was statistically significant (=2.257, =0.026). As for the secondary outcome indicators, no statistically significant difference was observed in the incidence of postoperative complications between the two groups (4.92% vs. 14.04%) (>0.05). The perioperative VAS scores in the two groups showed an interaction effect according to the repeated measurement variance test (<0.05). The postoperative VAS scores in both groups declined significantly compared to the preoperative scores (<0.05), and the VAS score decreased gradually over time after surgery (<0.05). The VAS scores in the combination group at 7 and 14 days after surgery were lower than those in the control group (<0.05). At 14 days after surgery, the scores for the coping and the task dimensions and the total score of SER increased in both groups compared with those at 3 days after surgery (<0.05), with the combination group showing higher scores than the control group did (<0.05). After surgery, the scores for the dimensions of deformity, pain, function, and joint mobility and the total score of the Harris Hip Scale revealed interaction effects in the two groups according to the repeated measurement variance test (<0.05), with these scores increasing gradually over time after surgery (<0.05), and the scores in the combination group were higher at 4 and 8 weeks after surgery compared to those in the control group (<0.05).

CONCLUSION

The combination of functional exercise based on dynamic and static complementary balance theory and stepwise rehabilitation training shows an advantage over stepwise rehabilitation training alone in enhancing the self-efficacy of THR patients, relieving the postoperative pain, shortening the length-of-stay, and improving the hip function in patients.

摘要

目的

分析基于动静互补平衡理论的功能锻炼联合阶段性康复训练在全髋关节置换术(THR)患者术后髋关节功能恢复中的应用价值。

方法

回顾性收集2022年6月至2023年6月期间118例行THR的住院患者的临床资料。其中,57例患者接受围手术期阶段性康复训练(对照组),61例患者在围手术期接受基于动静互补平衡理论的功能锻炼与阶段性康复训练相结合的方案(联合组)。记录两组患者术后恢复情况及术后并发症发生率。在术后恢复期间,采用视觉模拟评分法(VAS)评估患者疼痛情况,采用康复结局自我效能量表(SER)评估患者自我效能感。在术后2周、4周和8周测量并比较两组患者的髋关节功能。

结果

关于主要结局指标,联合组术后住院时间为(7.63±1.36)天,短于对照组的(8.22±1.48)天,差异有统计学意义(=2.257,=0.026)。对于次要结局指标,两组术后并发症发生率比较差异无统计学意义(4.92%对14.04%)(>0.05)。重复测量方差检验显示两组围手术期VAS评分存在交互效应(<0.05)。两组术后VAS评分均较术前显著下降(<0.05),且术后VAS评分随时间逐渐降低(<0.05)。联合组术后7天和14天的VAS评分低于对照组(<0.05)。术后14天,两组应对维度、任务维度评分及SER总分均较术后3天升高(<0.05)©联合组评分高于对照组(<0.05)。术后,重复测量方差检验显示两组畸形、疼痛、功能、关节活动度维度评分及Harris髋关节量表总分存在交互效应(<0.05),这些评分术后随时间逐渐升高(<0.05),联合组术后4周和8周的评分高于对照组(<0.05)。

结论

基于动静互补平衡理论的功能锻炼与阶段性康复训练相结合,在提高THR患者自我效能感、减轻术后疼痛、缩短住院时间及改善患者髋关节功能方面,相较于单纯阶段性康复训练具有优势。

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