以障碍点为指导的个性化综合训练对老年全髋关节置换伴肌少症患者运动能力及预后的影响

Effect of Individualized Comprehensive Training Guided by Obstacle Points on Motor Ability and Prognosis of Elderly Patients with Total Hip Replacement and Sarcopenia

目的 探讨以障碍点为指导的个性化综合训练用于老年全髋关节置换伴肌少症围术期的康复效果。方法 选取2020年2月—2023年4月收治的84例老年全髋关节置换伴肌少症,根据康复训练方法不同分为对照组、观察组,各42例。对照组给予常规康复训练,观察组给予以障碍点为指导的个性化综合训练。比较2组术前及术后1个月Fugl-Meyer运动功能量表(FMA)、Berg平衡量表(BBS)、髋关节残疾和骨关节炎预后评分(HOOS)、肌力相关指标、肌肉相关康复指标及肺功能[用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、FEV1/FVC、FEV1占预计值的百分比(FEV1%pred)]。结果 术后1个月,观察组FMA、BBS、HOOS评分较对照组升高,优势手握力、四肢骨骼肌质量、患肢骨骼肌质量和全身肌肉质量均较对照组升高,胫前屈肌厚度、肱二头肌厚度较对照组均降低(P<0.05);术后1个月,观察组FVC、FEV1、FEV1/FVC、FEV1%pred与对照组比较均升高(P<0.05)。结论 以障碍点为指导的个性化综合训练能提高老年全髋关节置换伴肌少症患者肌力与运动能力,利于改善肺功能及患者预后。

Objective To investigate the effect of individualized comprehensive training guided by obstacle points on perioperative rehabilitation of the elderly with total hip replacement and sarcopenia.Methods A total of 84 elderly patients with total hip replacement and sarcopenia treated from February 2020 to April 2023 were selected and divided into control group(n=42) and observation group(n=42) according to different rehabilitation training methods.The control group was given routine rehabilitation training,and the observation group was given individualized comprehensive training guided by obstacle points.Fugl-Meyer Motor Function Assessment(FMA),Berg Balance Scale(BBS),hip disability and osteoarthritis outcome score(HOOS),muscle strength-related indexes,muscle-related rehabilitation indexes and pulmonary function [forced vital capacity(FVC),forced expiratory volume in the first second(FEV1),FEV1/FVC,FEV1 as a percentage of predicted value(FEV1%pred)] were compared between the two groups before and at one month after surgery.Results At one month after surgery,FMA,BBS and HOOS scores in observation group were higher than those in control group,dominant hand grip strength,skeletal muscle mass of limbs,skeletal muscle mass of affected limb and total muscle mass were higher than those in control group,and the thickness of skeletal muscle tibialis flexor muscle and biceps muscle were lower than those in control group(P<0.05).At one month after surgery,FVC,FEV1,FEV1/FVC and FEV1%pred in the observation group were higher than those in the control group(P<0.05).Conclusion Individualized comprehensive training guided by obstacle points can improve the muscle strength and movement ability of elderly patients with total hip replacement and sarcopenia,and is conducive to improving pulmonary function and patient prognosis.