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全髋关节置换术后肌肉减少症的影响以及平衡与步态之间的功能关系

Impact of Sarcopenia and Functional Relationships Between Balance and Gait After Total Hip Arthroplasty.

作者信息

Kim So-Yeong, Cho Woon-Su, Park Chi-Bok, Kim Byeong-Geun

机构信息

Department of Physical Therapy, Graduate School, Nambu University, Gwangju 62271, Republic of Korea.

Rehabilitation Center, Gwangju 365 Rehabilitation Hospital, Gwangju 62232, Republic of Korea.

出版信息

J Clin Med. 2025 Mar 17;14(6):2036. doi: 10.3390/jcm14062036.

Abstract

: Total hip arthroplasty (THA) is an effective surgical intervention for restoring hip function and alleviating pain caused by osteoarthritis, femoral head avascular necrosis, or fractures. Despite its benefits, postoperative recovery is influenced by various factors, among which sarcopenia plays a critical role. This study aimed to analyze the characteristics of sarcopenia in THA patients admitted to a convalescent rehabilitation hospital and examine its relationship with functional variables such as balance and gait independence. : This cross-sectional study included 84 THA patients, categorized into sarcopenia and non-sarcopenia groups using the Asian Working Group for Sarcopenia 2019 criteria. Data were collected on demographic characteristics (e.g., age, gender, height, weight, range of motion (ROM), manual muscle test (MMT)) and functional variables, including balance (Berg Balance Scale, BBS) and gait independence (Functional Ambulation Category, FAC). : The prevalence of sarcopenia among THA patients was 44.05%. Significant differences were observed between the sarcopenia and non-sarcopenia groups in sex, age, height, weight, ROM, MMT, BBS, and FAC ( < 0.05). Logistic regression analysis showed that advanced age increased the likelihood of sarcopenia (OR: 1.072, < 0.05), whereas higher body weight reduced it (OR: 0.784, < 0.05). However, sarcopenia was not significantly associated with balance (BBS: = 0.710) or gait independence (FAC: = 0.990). Instead, a significant positive correlation was found between FAC and BBS (OR: 0.413, < 0.001), as well as BBS and FAC (OR: 0.467, < 0.001), indicating that better balance was associated with greater gait independence and vice versa. Additionally, patients who underwent THA due to fractures had a lower FAC compared to those with osteoarthritis (OR: -0.276, = 0.018). : Sarcopenia is prevalent among THA patients, and functional variables such as balance and gait independence are closely associated. Additionally, age and body weight were identified as key factors related to sarcopenia. These findings emphasize the importance of early detection and management of sarcopenia in rehabilitation hospital settings and highlight the significance of functional variables in recovery.

摘要

全髋关节置换术(THA)是一种有效的外科干预措施,用于恢复髋关节功能并减轻由骨关节炎、股骨头缺血性坏死或骨折引起的疼痛。尽管有诸多益处,但术后恢复受多种因素影响,其中肌肉减少症起着关键作用。本研究旨在分析康复疗养医院收治的THA患者中肌肉减少症的特征,并探讨其与平衡和步态独立性等功能变量之间的关系。

这项横断面研究纳入了84例THA患者,根据2019年亚洲肌肉减少症工作组标准分为肌肉减少症组和非肌肉减少症组。收集了人口统计学特征(如年龄、性别、身高、体重、活动范围(ROM)、徒手肌力测试(MMT))以及功能变量的数据,包括平衡(伯格平衡量表,BBS)和步态独立性(功能性步行分类,FAC)。

THA患者中肌肉减少症的患病率为44.05%。肌肉减少症组和非肌肉减少症组在性别、年龄、身高、体重、ROM、MMT、BBS和FAC方面存在显著差异(<0.05)。逻辑回归分析表明,高龄增加了肌肉减少症的可能性(比值比:1.072,<0.05),而较高的体重则降低了这种可能性(比值比:0.784,<0.05)。然而,肌肉减少症与平衡(BBS:=0.710)或步态独立性(FAC:=0.990)无显著相关性。相反,FAC与BBS之间存在显著正相关(比值比:0.413,<0.001),BBS与FAC之间也存在显著正相关(比值比:0.467,<0.001),这表明更好的平衡与更高的步态独立性相关,反之亦然。此外,因骨折接受THA的患者与骨关节炎患者相比,FAC较低(比值比:-0.276,=0.018)。

肌肉减少症在THA患者中很普遍,平衡和步态独立性等功能变量密切相关。此外,年龄和体重被确定为与肌肉减少症相关的关键因素。这些发现强调了在康复医院环境中早期检测和管理肌肉减少症的重要性,并突出了功能变量在恢复中的意义。

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