核心肌群强化训练对髋关节置换患者整体功能恢复的影响

doi:10.3969/j.issn.1006-9771.2017.10.010

《中国康复理论与实践》 ›› 2017, Vol. 23 ›› Issue (10): 1171-1175.doi: 10.3969/j.issn.1006-9771.2017.10.010

核心肌群强化训练对髋关节置换患者整体功能恢复的影响

张婷¹, 谢琪², 王健³, 张舒平², 王育庆², 申丽莉¹, 刘娟¹, 章莹¹, 吕晓宇², 尹庆水¹, 夏虹¹

1.广州军区广州总医院骨科医院,广东广州市 510010;
2. 广州军区广州总医院康复医学科,广东广州市 510010;
3.广州市中医医院骨伤科,广东广州市 510130

收稿日期:2017-03-03 修回日期:2017-05-24 出版日期:2017-10-25 发布日期:2017-11-03
通讯作者: 谢琪、吕晓宇。E-mail: xhuaqi@163.com (谢琪); Doctor_max@163.com (吕晓宇)。
作者简介:张婷(1988-),女,汉族,湖北荆州市人,康复治疗师,主要研究方向：骨科康复。
基金资助:
1.广州市科技计划科技惠民专项(No.2014Y2-00131); 2.广州市科技计划健康医疗协同创新重大专项(No.201508020253)

Effect of Intensive Core Muscles Training on General Function in Patients after Hip Arthroplasty

ZHANG Ting¹, XIE Qi², WANG Jian³, ZHANG Shu-ping², WANG Yu-qing², SHEN Li-li¹, LIU Juan¹, ZHANG Ying¹, LÜ Xiao-yu², YIN Qing-shui¹, XIA Hong¹

1. Guangzhou General Hospital of Guangzhou Military Orthopaedic Hospital, Guangzhou, Guangdong 510010, China;
2. Guangzhou General Hospital of Guangzhou Military Area Command Rehabilitation Physiotherapy, Guangzhou, Guangdong 510010, China;
3. Guangzhou City Hospital of Traditional Chinese Medicine and Traumatology, Guangzhou, Guangdong 510130, China

Received:2017-03-03 Revised:2017-05-24 Published:2017-10-25 Online:2017-11-03
Contact: XIE Qi, LÜ Xiao-yu. E-mail: xhuaqi@163.com (XIE Qi); Doctor_max@163.com (LÜ Xiao-yu)

摘要/Abstract

摘要： 目的观察核心肌群强化训练对老年股骨颈骨折髋关节置换患者整体功能恢复的影响。方法 2011年1月至2012年12月,60例因股骨颈骨折行髋关节置换患者,随机分为对照组(n=30)和观察组(n=30)。对照组予常规康复训练(每次50 min);观察组在常规康复训练(每次30 min)基础上,增加核心肌群强化训练,每次20 min。以上训练每天2次,每周5 d,连续治疗2周。训练前,训练1周、2周、3个月后分别采用Harris髋关节功能量表(HHS)评分、Charnley髋关节功能评分和改良Barthel指数(MBI)对两组进行评定。结果训练前及训练后1周,两组HHS评分、Charnley髋关节功能评分和MBI均无显著性差异(P>0.05)。各组训练后各评分均随时间显著增加(F>248.165, P<0.001)。训练后2周及训练后3个月,观察组各评分均显著高于对照组(t>3.211, P<0.001)。结论术后进行核心肌群强化训练,有助于提高老年髋关节置换患者的躯干稳定性,以及关节功能和日常生活活动能力的恢复。

关键词: 髋关节置换术, 运动疗法, 核心肌群, 老年, 跌倒

Abstract: Objective To observe the effect of the intensive training of core stabilization on the general function of patients with femoral neck fractures in old patients after hip arthroplasty.Methods From January, 2011 to December, 2012, 60 old patients accepted hip arthroplasty for femoral neck fractures were randomly divided into control group (n=30) and observation group (n=30). The control group received routine rehabilitation training 50 minutes each time, and the observation group received intensive training of core muscles 20 minutes each time based on the routine rehabilitation training 30 minutes each time, twice a day, five days a week for two weeks. Both groups were evaluated with Harris Hip Score (HHS), Charnley Hip Score (CHS) and modified Barthel Index (MBI) before training and one week, two weeks and three months after training.Results There was no significant difference in the scores of HHS, CHS and MBI before and one week after training (P>0.05). All the scores increased with time in both groups (F>248.165, P<0.001). The scores of HHS, CHS and MBI were significantly higher in the observation group than in the control group two weeks and three months after training (t>3.211, P<0.001).Conclusion Early intensive training of core stabilization may facilitate to recover hip function and activity of daily living in old patients after hip arthroplasty.

Key words: hip arthroplasty, motor therapy, core muscles, aged, fall

中图分类号:

R687.4

张婷, 谢琪, 王健, 张舒平, 王育庆, 申丽莉, 刘娟, 章莹, 吕晓宇, 尹庆水, 夏虹. 核心肌群强化训练对髋关节置换患者整体功能恢复的影响[J]. 《中国康复理论与实践》, 2017, 23(10): 1171-1175.

ZHANG Ting, XIE Qi, WANG Jian, ZHANG Shu-ping, WANG Yu-qing, SHEN Li-li, LIU Juan, ZHANG Ying, LÜ Xiao-yu, YIN Qing-shui, XIA Hong. Effect of Intensive Core Muscles Training on General Function in Patients after Hip Arthroplasty[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2017, 23(10): 1171-1175.

参考文献

[1] Frenkel Rutenberg T, Daglan E, Heller S, et al. A comparison of treatment setting for elderly patients with hip fracture, is the geriatric ward superior to conventional orthopedic hospitalization? [J]. Injury, 2017, 48(7): 1584-1588.
[2] 徐辰,毛远青,祝振安. 老年股骨颈骨折治疗进展[J]. 国际骨科学杂志, 2015, 36(2): 109-112.
[3] Kiss RM, Illyés Á. Comparison of gait parameters in patients following total hip arthroplasty with a direct-lateral or antero-lateral surgical approach [J]. Hum Mov Sci, 2012, 31(5): 1302-1316.
[4] 吴运明,郑鹏,楚云杰. 核心肌群训练对老年偏瘫患者跌倒的影响[J]. 中国老年学杂志, 2014, 34(20): 5648-5649.
[5] 张勃,丁玎,吕立. 本体感觉训练结合核心稳定性训练对脑卒中偏瘫患者下肢功能及平衡的影响[J]. 中国康复理论与实践, 2014, 20(12): 1109-1112.
[6] 寿依群,陈文君,李建华. 二周康复程序对全髋关节置换术患者短期ADL能力的影响[J]. 中华物理医学与康复杂志, 2005, 27(8): 476-477.
[7] Singh JA, Schleck C, Harmsen S, et al. Clinically important improvement thresholds for Harris Hip Score and its ability to predict revision risk after primary total hip arthroplasty [J]. BMC Musculoskelet Disord, 2016, 10(17): 256.
[8] Narkbunnam R, Amanatullah DF, Electricwala AJ, et al. Radiographic scoring system for the evaluation of stability of cementless acetabular components in the presence of osteolysis [J]. Bone Joint J, 2017, 99(5): 601-606.
[9] Kamal Alam B, Bukhari AS, Assad S, et al. Functional outcome after decompressive craniectomy in patients with dominant or non-dominant malignant middle cerebral infarcts [J]. Cureus, 2017, 9(1): e997.
[10] 张玉,陈蔚. 老年跌倒研究概况与进展[J]. 中国老年学杂志, 2008, 28(9): 929-931.
[11] 赵杰青,朱曙,张西金. 人工股骨头置换术治疗高龄股骨颈骨折[J]. 临床骨科杂志, 2014, 17(2): 176-177.
[12] Peter WF, Nelissen RG, Vlieland TP. Guideline recommendations for post-acute postoperative physiotherapy in total hip and knee arthroplasty: are they used in daily clinical practice? [J]. Musculoskeletal Care, 2014, 12(3): 125-131.
[13] Di Monaco M, Castiglioni C. Which type of exercise therapy is effective after hip arthroplasty? A systematic review of randomized controlled trials [J]. Eur J Phys Rehabil Med, 2013, 49(6): 893-907.
[14] Gill SD, McBurney H. Does exercise reduce pain and improve physical function before hip or knee replacement surgery? A systematic review and meta-analysis of randomized controlled trials [J]. Arch Phys Med Rehabil, 2013, 94(1): 164-176.
[15] 周海林. 系统康复训练对老年股骨颈骨折髋关节置换术后髋关节功能的影响[J]. 中国老年学杂志, 2011, 31(10): 4063-4065.
[16] 宋莹. 风险管理在预防老年关节置换患者术后跌倒中的应用效果分析[J]. 中国伤残医学, 2015, 23(8): 194-195.
[17] 方瑛,李敏,陈洪飞. 风险管理在预防老年关节置换患者术后跌倒中的应用[J]. 解放军护理杂志, 2014, 31(7): 60-62.
[18] 刘善云,陈东烨,连志强,等. 核心力量练习对男性老年人下肢肌力、平衡能力与跌倒风险的干预效果[J]. 中国运动医学杂志, 2015, 34(12): 1139-1151.
[19] 韩春远,王卫星. 核心力量训练的基本问题——核心区与核心稳定性[J]. 天津体育学院学报, 2012, 27(2): 117-120.
[20] Coulombe BJ, Games KE, Neil ER, et al. Core stability exercise versus general exercise for chronic low back pain [J]. J Athl Train, 2017, 52(1): 71-72.
[21] 黎涌明,于洪军,资薇,等. 论核心力量及其在竞技体育中的训练——起源?问题?发展[J]. 体育科学, 2008, 28(4): 19-29.
[22] Stivala A, Hartley G. The effects of a Pilates-based exercise rehabilitation program on functional outcome and fall risk reduction in an aging adult status-post traumatic hip fracture due to a fall [J]. J Geriatr Phys Ther, 2014, 37(3): 136-145.
[23] 韩春远,赵晓雯,王卫星,等. 运动员核心力量训练的本质[J]. 体育学刊, 2013, 20(5): 112-118.
[24] Kim H, Lee Y, Shin I, et al. Effects of 8 weeks' specific physical training on the rotator cuff muscle strength and technique of javelin throwers [J]. J Phys Ther Sci, 2014, 26(10): 1553-1556.
[25] 吴方超,李建华,蒋红. 腰椎间盘突出症患者首次核心稳定性训练前后表面肌电信号分析[J]. 全科医学临床与教育, 2013, 11(6): 643-646.
[26] Tyč F, Boyadjian A. Plasticity of motor cortex induced by coordination and training [J]. Clin Neurophysiol, 2011, 122(1): 153-162.
[27] 刘烜伟,赵娜娜,肖鹏. 核心肌群训练对脑卒中患者平衡机步行能力的影响[J]. 中国康复, 2012, 27(5): 361-362.
[28] Oliver GD, Stone AJ, Plummer H. Electromyographic examination of selected muscle activation during isometric core exercises [J]. Clin J Sport Med, 2010, 20(6): 452-457.
[29] Rivera CE. Core and lumbopelvic stabilization in runners [J]. Phys Med Rehabil Clin N Am, 2016, 27(1): 319-337.
[30] 赵佳. 我国高水准网球运动员力量训练理论与实践[D]. 北京:北京体育大学,2009.
[31] 袁冰,李雪萍,林强,等. 核心肌群训练对脑卒中偏瘫患者平衡功能的影响[J]. 中华临床医师杂志(电子版),2013, 7(15): 91-94.
[32] 沈怡,王文威,陈艳,等. 核心稳定性训练对脑卒中偏瘫患者站立平衡和步行能力的影响[J]. 中国康复医学杂志, 2013, 28(9): 830-833.

核心肌群强化训练对髋关节置换患者整体功能恢复的影响

Effect of Intensive Core Muscles Training on General Function in Patients after Hip Arthroplasty

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

Metrics

本文评价

推荐阅读 0

[1]	王航宇, 葛可可, 范永红, 都丽露, 邹敏, 封磊. 基于ICD-11和ICF主动式音乐疗法改善认知障碍老年人认知功能的系统综述[J]. 《中国康复理论与实践》, 2024, 30(1): 36-43.
[2]	葛可可, 范永红, 王航宇, 都丽露, 李长江, 邹敏. 失眠老年人正念干预健康效益的系统综述[J]. 《中国康复理论与实践》, 2024, 30(1): 54-60.
[3]	杨雅楠, 穆丽萍, 邢凤梅, 薛新宏, 王晓光, 陶徉聿, 孙竹梅, 张小丽. 基于计划行为理论的干预对肌少症老年人肌肉衰减状况及平衡能力的效果[J]. 《中国康复理论与实践》, 2023, 29(8): 869-874.
[4]	蒋长好, 黄辰, 高晓妍, 戴元富, 赵国明. 神经反馈训练对老年人认知功能效果的系统综述[J]. 《中国康复理论与实践》, 2023, 29(8): 903-909.
[5]	武广艳, 张冉, 王璐, 于歌, 陈亚平. 核心肌群运动控制训练对产后腹直肌分离的效果[J]. 《中国康复理论与实践》, 2023, 29(8): 948-953.
[6]	马甜甜, 于子夫, 秦芳, 冷晓轩, 刘西花. 强制性运动疗法在康复领域应用的可视化分析[J]. 《中国康复理论与实践》, 2023, 29(7): 822-832.
[7]	谭晓欢, 姜桂萍, 黄芯怡, 王丹丹, 张磊, 卜庆国, 吴雪萍. 社区高龄老年人下肢肌力与步速的关系：柔韧和动态平衡的链式中介作用[J]. 《中国康复理论与实践》, 2023, 29(6): 646-653.
[8]	朱晓敏, 刘惠林, 刘元旻, 闫志宇, 杜雪晶, 王亚囡, 张通. 脑卒中患者步行中自发性转身方向与平衡和跌倒风险间的关系[J]. 《中国康复理论与实践》, 2023, 29(5): 510-515.
[9]	袁媛, 杨剑. 社区老年人身体活动融合慢性病管理的健康效益：Scoping综述[J]. 《中国康复理论与实践》, 2023, 29(5): 541-550.
[10]	罗启航, 吴羽皙, 张嘉璇, 黎婉颖, 欧海宁, 林强, 梁俊杰. 老年人平衡功能的脑网络变化：基于功能性近红外线光谱研究[J]. 《中国康复理论与实践》, 2023, 29(2): 238-242.
[11]	乔虎军, 郝鑫, 刘晓燕, 王国祥. 肌少症老年人运动康复的健康效益：系统综述的系统综述[J]. 《中国康复理论与实践》, 2023, 29(11): 1296-1303.
[12]	朱烈烈, 夏建宁, 蒲新宇, 邵湘芝, 张嘉诚, 吴登宠. 老年营养风险指数对脑卒中后神经功能预后的效能[J]. 《中国康复理论与实践》, 2023, 29(11): 1346-1352.
[13]	吴佳玉, 孟德涛, 梁潇潇. 体力活动水平对帕金森病发病风险的影响：基于CHARLS数据的横断面分析[J]. 《中国康复理论与实践》, 2023, 29(10): 1135-1139.
[14]	刘梦雅, 张利, 张梦, 宋楠楠, 周静蕾. 中国老年人内在能力与日常生活活动的相关性：基于CHARLS数据[J]. 《中国康复理论与实践》, 2023, 29(10): 1140-1146.
[15]	唐家玉, 邱服冰. 老年人心理社会干预与心理健康的系统综述[J]. 《中国康复理论与实践》, 2023, 29(10): 1164-1170.