Li Li, Wei Li, Zhang Jie, Pu Jin-Chan, Lv Xiao-Ming, Huang Ming-Wei
Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China.
Oral Oncol. 2025 Feb;161:107150. doi: 10.1016/j.oraloncology.2024.107150. Epub 2025 Jan 4.
This trial was aimed at investigating the effects of progressive functional training on hip mobility, lower-limb stability, quality of life, and hip complications in patients who have undergone jaw defect reconstruction using vascularized iliac flaps.
Patients who underwent reconstruction surgery with vascularized iliac flaps were randomly divided into control and training groups. The control group, according to routine nursing practice, only received activity and safety guidance after the operation. The training group received progressive functional training for functional exercise. The primary outcomes were donor area function-Harris hip score and the timed "Up and Go" test. Secondary outcomes were patients' quality of life, the hip visual analog scale, and other complications. Observations and evaluations were performed before the surgery and on postoperative day 7 and at months 1, 3, 6, and 12.
The donor area function and quality of life of the patients in the training group were significantly improved at 1, 3, 6, and 12 months after surgery, and the differences were statistically significant. The load-dependent pain in the training group was significantly reduced compared with that in the control group. The incidence rates of gait disturbance at postoperative months 3, and 6 in the training group were significantly lower than the corresponding rates in the control group (P < 0.05).
Progressive functional training can accelerate the restoration of hip function and stability of lower-limb movement, alleviate gait disorders, relieve pain, and improve patients' quality of life.
本试验旨在研究渐进性功能训练对采用带血管蒂髂骨瓣进行颌骨缺损重建患者的髋关节活动度、下肢稳定性、生活质量及髋关节并发症的影响。
采用带血管蒂髂骨瓣进行重建手术的患者被随机分为对照组和训练组。对照组按照常规护理，术后仅接受活动及安全指导。训练组接受渐进性功能训练以进行功能锻炼。主要结局指标为供区功能- Harris髋关节评分及定时起立行走试验。次要结局指标为患者生活质量、髋关节视觉模拟评分及其他并发症。在手术前、术后第7天以及术后1、3、6和12个月进行观察和评估。
训练组患者术后1、3、6和12个月时供区功能及生活质量显著改善，差异具有统计学意义。训练组与负荷相关的疼痛较对照组显著减轻。训练组术后3个月和6个月时步态障碍的发生率显著低于对照组（P<0.05）。
渐进性功能训练可加速髋关节功能恢复及下肢运动稳定性，减轻步态障碍，缓解疼痛，并改善患者生活质量。
