目的 评估渐进式阻力复合训练(progressive resistance compound training,PRCT)对老年髋关节置换术(hip arthroplasty,HA)患者术后步行能力、髋部功能、生活能力、生活质量和并发症影响.方法 选取我院 2019 年 7 月至 2022 年 6 月 100 例老年 HA 患者,对照组和观察组各 50 例.对照组采用基础康复训练,观察组在此基础上结合 PRCT.通过 6 分钟步行测试(6-min walk test,6-MWT)、简易体能状况量表(short physical performance battery,SPPB)、改良体能测试(modified physical performance test,MPPT)、起立-行走计时测试(timed up and go test,TUGT)、Harris 髋关节功能评分(Harris hip score,HHS)、日常生活能力量表(activity of daily living scale,ADL)和健康调查简表(36-item short form,SF-36)评估术后步行能力、髋部功能、生活能力和生活质量.结果 术后 12 周,观察组 6-MWT 距离(t=2.642,P=0.001)、SPPB(t=2.268,P=0.026)、MPPT(t=4.242,P<0.001)高于对照组,TUGT(t=6.834,P<0.001)低于对照组,差异有统计学意义(P<0.05);观察组 HHS 评分(t=7.814,P<0.001)高于对照组,差异有统计学意义(P<0.05);观察组 ADL(t=5.683,P<0.001)及 SF-36 评分(t=2.703,P<0.008)均高于对照组,差异有统计学意义(P<0.05).观察组并发症发生率低于对照组(14.0%vs.32.0%,P=0.032).结论 PRCT 能够有效改善老年全 HA患者术后步行能力、髋部功能、生活能力、生活质量,降低并发症,适合在临床推广使用.
The clinical application value of progressive resistance composite training in elderly patients after hip replacement surgery
Objective To assess the effects of progressive resistance compound training(PRCT)on postoperative walking ability,hip function,livability,quality of life and complications in elderly hip arthroplasty(HA)patients.Methods We selected 100 cases of elderly HA patients between July 2019 and June 2022 in our hospital,with 50 cases in the control group and 50 cases in the observation group.In the control group,basic rehabilitation training was used;and in the observation group,PRCT was combined on this basis.6-min walk test(6-MWT),short physical performance battery(SPPB),modified physical performance test(MPPT),timed up and go test(TUGT),were used to assess the physical performance of the patients.Harris hip score(HHS),activity of daily living scale(ADL),and health survey short form(36-item short form,SF-36)were used to assess postoperative walking ability,hip function,living ability and quality of life.Results At 12 weeks postoperatively,the 6-MWT distance(t=2.642,P=0.001),SPPB(t=2.268,P=0.026),and MPPT(t=4.242,P<0.001)were higher in the observation group than in the control group,and the TUGT(t=6.834,P<0.001)was lower than in the control group,with statistically significant differences(P<0.05).HHS score of the observation group(t=7.814,P<0.001)was higher than that of the control group,and the differences were statistically significant(P<0.05);ADL of the observation group(t=5.683,P<0.001)and SF-36 score(t=2.703,P<0.008)were higher than that of the control group,and the differences were statistically significant(P<0.05).The complication rate of the observation group was lower than that of the control group(14.0%vs.32.0%,P=0.032).Conclusions PRCT can effectively promote postoperative walking ability,hip function,livability,and quality of life in the elderly patients with total HA,reducing complications.It is recommended in the clinic.
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