术前预康复对全髋关节置换术后功能锻炼及运动耐力的影响

目的 探讨术前预康复在全髋关节置换（THA）术后患者关节功能和运动耐力中的干预效果。方法 80例THA患者随机分为实验组与对照组，每组各40例。对照组接受常规术前教育，实验组接受预康复训练。两组患者均在入院、术前1天、术后第2天、术后1周、术后2周使用Harris髋关节功能量表 (HHS)、Charnley髋关节功能评分量表（CHS）和6分钟步行试验（6MWT）来评估患者的关节功能及运动耐力状况。使用t检验、重复测量分析评估其干预效果。结果 经预康复训练后，实验组不同时间点HHS、CHS和6MWT有统计学意义(P<0.05)；且组别和时间在HHS、CHS和6MWT上有交互作用。实验组HHS在术前1天、术后1周、术后2周均优于对照组（t=3.594、2.437、5.891，P<0.05）；实验组CHS在术前1天、术后1周、术后2周均优于对照组（t=2.318、3.724、6.439，P<0.05）；实验组6MWT在术前1天、术后1周、术后2周均优于对照组（t=3.878、5.891、8.750，P<0.05）。简单效应示，术前预康复对改善患者的HHS、CHS和6MWT直接及持续作用有统计学意义(P<0.05)。结论 术前预康复可改善THA术后患者关节功能和提升运动耐力，且随着时间改变，效果显著。

Effect of preoperative rehabilitation on functional exercise and sports endurance after total hip arthroplasty

To investigate the effect of preoperative rehabilitation on joint function and exercise endurance of patients after total hip arthroplasty. Methods 80 patients with total hip arthroplasty were randomly divided into experimental group and control group, with 40 cases in each group. From admission to preoperative, the control group only received routine preoperative education, and the experimental group received systematic prehabilitation. Both groups of patients used Harris Hip Score(HHS), Charnley Hip Score(CHS) and 6-minute walk test(6 MWT) on admission, the second day after operation, 1 week after operation, and 2 weeks after operation, and their intervention effects were compared by t-test and repeated measurement analysis. Results After prehabilitation training, there were significant differences in HHS, CHS and 6 MWT at different time points in the experimental group(P<0.05), and group and time had an interactive effect on HHS, CHS and 6 MWT. The HHS of the experimental group was better than the control group(P<0.05) at 1 day before surgery, 1 week after surgery, and 2 weeks after surgery. CHS in the experimental group before surgery 1 day, 1 week after operation, 2 weeks after operation were better than the control group(P<0.05). 6 MWT in the experimental group was 1 day before operation, 1 week after operation, 2 weeks after operation were better than the control group(P<0.05). Simple effect showed that preoperative rehabilitation had a direct and continuous effect on improving patients’ HHS, CHS and 6 MWT. Conclusion Preoperative rehabilitation can improve the joint function and exercise endurance of patients after total hip arthroplasty. With the time, the effect is remarkable.