■分析基于动态和静态互补平衡理论的功能锻炼结合逐步康复训练在全髋关节置换术(THR)患者术后髋关节功能恢复中的应用价值。
■回顾性收集了2022年6月至2023年6月期间118例接受THR的住院患者的临床资料。在患者中,57例患者给予围手术期逐步康复训练(对照组),61例患者在围手术期给予基于静态和动态互补平衡理论的功能锻炼和逐步康复训练相结合(联合组)。记录两组患者术后恢复情况及术后并发症发生率。在术后恢复期间,采用视觉模拟评分法(VAS)对患者进行疼痛评估,采用康复结果自我效能量表(SER)对患者进行自我效能评估.2周时测量并比较两组患者的髋关节功能,术后4周和8周。
■关于主要结果指标,联合组术后住院时间为(7.63±1.36)d,短于对照组的(8.22±1.48)d,差异有统计学意义(t=2.257,P=0.026)。至于次要结果指标,两组术后并发症发生率无统计学差异(4.92%vs.14.04%)(P>0.05)。两组围手术期VAS评分经重复测量方差检验呈交互效应(P<0.05)。两组患者术后VAS评分较术前均有明显下降(P<0.05),术后VAS评分随时间逐渐降低(P<0.05)。联合组术后7、14d的VAS评分均低于对照组(P<0.05)。手术后14天,与术后3d相比,两组的应对和任务维度得分以及SER总分均增加(P<0.05)。联合组评分高于对照组(P<0.05)。手术后,畸形尺寸的分数,疼痛,函数,关节活动度和Harris髋关节量表总分根据重复测量方差检验显示两组的交互效应(P<0.05),随着手术后时间的推移,这些分数逐渐增加(P<0.05),联合组术后4周和8周评分高于对照组(P<0.05)。
■基于动静互补平衡理论的功能锻炼与阶梯式康复训练相结合,在增强THR患者自我效能感上,显示出较单纯阶梯式康复训练的优势,减轻术后疼痛,缩短停留时间,改善患者的髋关节功能。
UNASSIGNED: To analyze the application value of dynamic and static complementary balance theory-based functional exercise combined with stepwise rehabilitation training in postoperative hip function recovery in patients undergoing total hip replacement (THR).
UNASSIGNED: The clinical data of 118 inpatients undergoing THR between June 2022 and June 2023 were retrospectively collected. Among the patients, 57 were given perioperative stepwise rehabilitation training (the control group), and 61 were given a combination of functional exercise based on static and dynamic complementary balance theory and stepwise rehabilitation training during the perioperative period (the combination group). The postoperative recovery status and the incidence of postoperative complications in the two groups were recorded. During postoperative recovery, the patients were assessed for pain with the visual analogue scale (VAS) and for self-efficacy with the Self-Efficacy for Rehabilitation Outcome Scale (SER). Hip function was measured and compared between the two groups at 2 weeks, 4 weeks and 8 weeks after surgery.
UNASSIGNED: With regard to the primary outcome indicator, the postoperative length-of-stay was (7.63±1.36) d in the combination group, which was shorter than the (8.22±1.48) d in the control group, and the difference was statistically significant (t=2.257, P=0.026). As for the secondary outcome indicators, no statistically significant difference was observed in the incidence of postoperative complications between the two groups (4.92% vs. 14.04%) (P>0.05). The perioperative VAS scores in the two groups showed an interaction effect according to the repeated measurement variance test (P<0.05). The postoperative VAS scores in both groups declined significantly compared to the preoperative scores (P<0.05), and the VAS score decreased gradually over time after surgery (P<0.05). The VAS scores in the combination group at 7 and 14 days after surgery were lower than those in the control group (P<0.05). At 14 days after surgery, the scores for the coping and the task dimensions and the total score of SER increased in both groups compared with those at 3 days after surgery (P<0.05), with the combination group showing higher scores than the control group did (P<0.05). After surgery, the scores for the dimensions of deformity, pain, function, and joint mobility and the total score of the Harris Hip Scale revealed interaction effects in the two groups according to the repeated measurement variance test (P<0.05), with these scores increasing gradually over time after surgery (P<0.05), and the scores in the combination group were higher at 4 and 8 weeks after surgery compared to those in the control group (P<0.05).
UNASSIGNED: The combination of functional exercise based on dynamic and static complementary balance theory and stepwise rehabilitation training shows an advantage over stepwise rehabilitation training alone in enhancing the self-efficacy of THR patients, relieving the postoperative pain, shortening the length-of-stay, and improving the hip function in patients.