渐进抗阻训练对骨质疏松性股骨颈骨折患者髋关节置换术后康复效果的影响

Effect of progressive resistance training on rehabilitation of patients with osteoporotic femoral neck fracture after hip arthroplasty

目的探讨渐进抗阻训练对骨质疏松性股骨颈骨折患者髋关节置换术后康复效果的影响。方法选择上海交通大学医学院附属新华医院2017年6月至2019年6月行髋关节置换术的98例骨质疏松性股骨颈骨折患者为研究对象,依据随机数字表法将其分为观察组和对照组,每组各49例。对照组患者术后采取常规康复训练,观察组患者术后在常规康复训练的基础上采取渐进抗阻训练。两组患者训练时间均为12周。比较两组患者手术时间、术中出血量、术前和术后12周6 min步行距离、视觉模拟评分法(visual analogue score,VAS)评分、Harris髋关节评分(Harris hip score,HHS)、改良Barthel指数(modified Barthel index,MBI)评分及并发症发生情况。结果两组患者手术时间和术中出血量比较差异均无统计学意义(均P>0.05)。两组患者术后12周6 min步行距离均显著长于本组术前(均P<0.05),VAS评分均显著低于本组术前(均P<0.05),HHS和MBI评分均显著高于本组术前(均P<0.05);观察组患者术后12周6 min步行距离显著长于对照组(P<0.05),VAS评分显著低于对照组(P<0.05),HHS和MBI评分均显著高于对照组(均P<0.05)。观察组患者术后并发症发生率显著低于对照组(P<0.05)。结论渐进抗阻训练可提高骨质疏松性股骨颈骨折患者髋关节置换术后康复效果,改善患者髋关节功能、步行能力和日常生活能力,减轻疼痛,减少并发症。

Objective To explore the effect of progressive resistance training on rehabilitation of patients with osteoporotic femoral neck fracture after hip arthroplasty.Method A total of 98 patients with osteoporotic femoral neck fracture who underwent hip arthroplasty from June 2017 to June 2019 were randomly divided into observation group and control group,49 cases in each group.Patients in control group were treated with routine rehabilitation training after operation,while patients in observation group were treated with progressive resistance training on the basis of routine rehabilitation training.The course of treatment in both groups was 12 weeks.The operation time,intraoperative blood loss,6 min walking distance,visual analogue score(VAS)score,Harris hip score,modified Barthel index(MBI)score before and 12 weeks after operation and the complications were compared between the two groups.Result There were no significant differences in operation time and bleeding volume between the two groups(all P>0.05).Twelve weeks after operation,the 6 min walking distances in both groups were significantly longer than those before operation(all P<0.05),the VAS scores were significantly lower than those before operation(all P<0.05),and the HHS and MBI scores were significantly higher than those before operation(all P<0.05).Twelve weeks after operation,the 6 min walking distance in observation group was significantly longer than that of control group(P<0.05),the VAS score were significantly lower than that of control group(P<0.05),and the HHS and MBI scores were significantly higher than those of control group(all P<0.05).The incidence of complications in observation group was significantly lower than that of control group(P<0.05).Conclusion Progressive resistance training can improve the rehabilitation effect on patients with osteoporotic femoral neck fracture after hip arthroplasty,it can improve the osteoporotic femoral neck fracture of hip joint,walking ability and daily life ability,reduce pain and complications.