经皮神经电刺激臀部肌群对THA后患者下肢肌力恢复的临床研究

Clinical study on the recovery of lower extremity muscle strength after THA by transcutaneous electrical nerve stimulation of hip muscle groups

目的研究经皮神经电刺激(TENS)臀部肌群对全髋关节置换术(THA)后患者下肢肌力恢复的影响。方法选取2020年1月至2021年6月河南科技大学第二附属医院收治的股骨颈骨折行单侧人工THA患者126例,采用随机数字表法分为对照组、训练组和干预组,每组42例。对照组术后给予常规康复功能训练,训练组采用训练带增加对臀大肌、臀中肌的锻炼,干预组在训练组基础上加用TENS。测定3组患者术后1、3、6个月髋关节Harris评分、Barthel指数,以及术后3个月健侧、患侧臀大肌及臀中肌峰力矩、功率值及总做功量等相关指标。结果干预组、训练组患者术后1、3、6个月髋关节Harris评分、Barthel指数均明显高于对照组,干预组患者术后1、3、6个月髋关节Harris评分、Barthel指数均明显高于训练组,差异均有统计学意义(P<0.05)。干预组、训练组患者术后3个月峰力矩、功率值及总做功量均明显高于对照组,差异均有统计学意义(P<0.05);干预组患者术后3个月峰力矩、功率值及总做功量与训练组比较,差异均无统计学意义(P>0.05)。结论TENS臀部肌群联合臀大肌、臀中肌锻炼可改善患者术后髋关节Harris评分及Barthel指数,可增加髋周肌群肌力,具有一定的临床推广应用意义。

Objective To study the effect on the recovery of lower extremity muscle strength after total hip arthroplasty(THA)by transcutaneous electrical nerve stimulation(TENS)of hip muscle groups.Methods A total of 126 patients with femoral neck fracture undergoing unilateral artificial THA in this hospital from January 2020 to June 2021 were selected,and were divided into the control group,the training group and the intervention group by the random number table method,with 42 cases in each group.The control group received routine rehabilitation function training after surgery,In the intervevtion group,TENS was added to the training group.Harris score and Barthel index of hip joint in the three groups were determined at 1,3 and 6 months after operation.And the peak torque,power value and total work of the gluteus maximus and gluteus medius on the healthy and affected sides were measured at three months after operation.Results The Harris score and Barthel index of hip joint in the intervention group and the training group were siginificantly higher than those in the control group at 1,3 and 6 months after operation,and the intervention group was higher than the training group,and the differences were statistically significant(P<0.05).The peak torque,power value and total work of patients in the intervention group and training group were higher than those in the control group at three months after operation,and the differences were statistically significant(P<0.05).There were no significant differences in peak torque,power value and total work of patients between the intervention group and the training group at three months after operation(P>0.05).Conclusion TENS of the hip muscle group combined with exercise of the gluteus maximus and gluteus medius can improve the postoperative Harris score and Barthel index of the hip joint,and increase the strength of the perihip muscle group,which has certain clinical significance.