老年股骨颈骨折患者髋关节置换术后体力活动现状及其影响因素分析

Analysis of physical activity status and influencing factors in elderly patients receiving hip replacement surgery for femoral neck fractures

目的 观察老年股骨颈骨折(FNF)患者髋关节置换术后体力活动现状,并探析患者术后体力活动的影响因素。方法 选择2021年5月-2023年9月本院收治的拟行髋关节置换术治疗的150例老年FNF患者为研究对象,统计患者术后6个月时体力活动[采用国际身体活动短问卷(IPAQ-LF)评估]水平,设计基线资料调查表,比较不同基线资料特征下老年FNF患者术后体力活动水平,采用有序分类多元回归分析检验老年FNF患者髋关节置换术后体力活动水平的影响因素。结果 经评估,150例老年FNF患者经髋关节置换术治疗后6个月,经IPAQ-LF评估为低体力活动水平者31例,占比为20.67%(31/150);91例老年FNF患者术后体力活动水平为中等水平,占比为60.67%(91/150);28例老年FNF患者术后体力活动水平为中等水平,占比为18.66%(28/150)。初步比较不同基线资料特征老年FNF患者髋关节置换术后体力活动水平行单因素分析发现,超重及肥胖、骨质疏松、自我效能低下、合并恐动症可能是老年FNF患者术后体力活动低水平的影响因素(P<0.05)。经有序分类多元回归分析结果显示,体重指数(过低、超重及肥胖)、致病因素(骨质疏松)、自我效能感(低下)、合并恐动症均是老年FNF患者髋关节置换术后体力活动水平的低下的影响因素(P<0.05)。结论 老年FNF患者髋关节置换术后体力活动水平普遍不高,可能受患者超重及肥胖、致病因素为骨质疏松、自我效能低下、合并恐动症等因素影响,临床应引起重视。

Objective To investigate the current status of physical activity and its influencing factors in elderly patients with femoral neck fracture(FNF)following hip replacement surgery.Methods A total of 150 elderly FNF patients admitted to our hospital and scheduled for hip replacement surgery from May 2021 to September 2023 were included in the study.Physical activity levels at 6 months post-surgery were statistically analyzed using the International Physical Activity Short Form Questionnaire(IPAQ-LF).A baseline data questionnaire was developed to compare postoperative physical activity levels among elderly FNF patients with different baseline characteristics.Ordered classification multiple regression analysis was applied to examine the influencing factors of physical activity levels in elderly FNF patients after hip replacement surgery.Results Upon evaluation,31 out of 150 elderly FNF patients who underwent hip replacement surgery were assessed as having low physical activity levels by IPAQ-LF,representing 20.67%(31/150);91 patients had a moderate level of physical activity,representing 60.67%(91/150);and 28 patients had a high level of physical activity,representing 18.66%(28/150).Univariate analysis indicated that being overweight or obese,osteoporosis,low self-efficacy,and comorbid anxiety disorder might be influencing factors for low postoperative physical activity levels in elderly FNF patients undergoing hip replacement(P<0.05).Ordered classification multiple regression analysis revealed that body mass index(underweight,overweight,and obesity),etiological factors(osteoporosis),low self-efficacy,and comorbid anxiety disorder were all significant factors affecting low physical activity levels in elderly FNF patients after hip replacement surgery(P<0.05).Conclusions The physical activity levels of elderly FNF patients after hip replacement surgery are generally low and may be influenced by factors such as overweight and obesity,osteoporosis,low self-efficacy,and comorbid anxiety disorder.Clinical attention should be given to these factors.