Elibol Nuray, Unver Bayram, Karatosun Vasfi
Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Ege University, Izmir, Turkey.
Department of Orthopedics Physiotherapy, Faculty of Physiotherapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey.
Orthopadie (Heidelb). 2024 Dec;53(12):955-965. doi: 10.1007/s00132-024-04570-y. Epub 2024 Oct 11.
Total hip arthroplasty (THA) causes damage to hip joint mechanoceptors, which in turn leads to decrease in proprioception and increase in balance disorders. Few research has focused on balance training in patients with arthroplasty and none investigated the long-term effect of balance training using objective balance assessment methods in THA patients. The purpose of our study was to investigate the effects of balance training in patients with THA until 26 weeks postoperatively.
For this study 24 patients with hip osteoarthritis, who were candidates for THA were recruited. Of the patients with THA 16 completed the study protocol and the patients were randomized to 2 groups: conventional rehabilitation (CR, n = 8) or conventional rehabilitation plus balance training (CR + BT, n = 8). The CR group completed typical surgery-specific exercise programs, while the CR + BT group completed the CR plus balance exercises. The patients were evaluated by a hand-held dynamometer, single leg stance test (SLST), Tetrax balance system, Harris hip score, lower extremity function scale, 5 times sit to stand test and 50-foot timed walk test preoperatively and 8, 14 and 26 weeks postoperatively.
While the CR + BT group showed significant improvement for the right extremity eyes closed SLST score (p < 0.05), there was no significant difference for other assessment parameters between the CR and CR + BT groups (p > 0.05). There were significant improvements in both groups until 26 weeks following THA (p < 0.05).
The results of our study indicate that there were similar improvements in the balance and functional parameters in the CR and CR + BT groups. There was no additional benefit after 26 weeks of controlled balance exercises following THA.
全髋关节置换术(THA)会损伤髋关节机械感受器,进而导致本体感觉下降和平衡障碍增加。很少有研究关注关节置换术后患者的平衡训练,且没有研究使用客观平衡评估方法来调查THA患者平衡训练的长期效果。我们研究的目的是调查THA患者平衡训练至术后26周的效果。
本研究招募了24例髋关节骨关节炎患者,这些患者均为THA的候选对象。其中16例THA患者完成了研究方案,患者被随机分为两组:传统康复组(CR,n = 8)或传统康复加平衡训练组(CR + BT,n = 8)。CR组完成典型的特定手术锻炼计划,而CR + BT组完成CR加平衡锻炼。在术前以及术后8周、14周和26周,通过手持测力计、单腿站立试验(SLST)、Tetrax平衡系统、Harris髋关节评分、下肢功能量表、5次坐立试验和50英尺定时步行试验对患者进行评估。
虽然CR + BT组右侧下肢闭眼SLST评分有显著改善(p < 0.05),但CR组和CR + BT组之间的其他评估参数无显著差异(p > 0.05)。两组在THA术后26周之前均有显著改善(p < 0.05)。
我们的研究结果表明,CR组和CR + BT组在平衡和功能参数方面有相似的改善。THA术后进行26周的控制性平衡锻炼后没有额外益处。