Abstract:

Objective To develop a progressive balance training program and to explore effects of early rehabilitation after total hip arthroplasty. Methods Through evidence-based retrieval,in-hospital revision,and pre-experiment,the progressive balance training program after total hip arthroplasty was formulated. Totally 65 patients under total hip arthroplasty in the Department of Orthopedic Trauma,a tertiary hospital in Suzhou,were included from January to August 2019 by convenient sampling,with 36 patients in an experimental group and 29 patients in a control group by bed arrangement. The experimental group was given the progressive balance training on the basis of routine exercise,while the control group was given a routine exercise program. The Berg Balance Scale（BBS）,the Time Up and Go Test（TUGT）,and Modified Fall Efficacy Scale（MFES） were used to measure and compare the differences of rehabilitation between 2 groups at 1,2,4 and 8 weeks after operation. Results The results of repeated measurement analysis of variance showed that the time,interaction and inter group effects of BBS and TUGT were statistically significant（F_time=1 645.43,F_{time × group}=73.51,F_group=761.72;F_time=4 289.34,F_{time × group}=72.83,F_group=231.43,P<0.05）. Non-parametric test showed that there were significant differences in MFES scores between 2 groups at 4 and 8 weeks after operation（Z=-4.09,P<0.001;Z=-2.65,P<0.01）. Conclusion The progressive balance training program can accelerate the recovery of balance ability and walking ability of patients in the early stage of rehabilitation after total hip arthroplasty,improve fall efficiency of patients,and improve fear of falling of patients.

Key words: Arthroplasty, Replacement, Hip, Postural Balance, Progressive Training, Rehabilitation Nursing

摘要：

目的 制订渐进式平衡训练方案,并探讨其在全髋关节置换术后患者康复早期中的应用效果。 方法 通过循证检索、院内修订、预试验等环节,制订全髋关节置换术后渐进式平衡训练方案。便利抽取2019年1月—8月入住苏州市某三级甲等医院骨伤科,首次行全髋关节置换术患者65例,依据床位安排分为试验组36例,对照组29例。试验组在常规锻炼的基础上给予渐进式平衡训练方案,对照组采用常规锻炼方案。使用Berg平衡量表、起立行走计时测试、中文版跌倒效能量表测量并比较两组干预前,术后1周、2周、4周、8周的康复效果。结果 重复测量方差分析结果显示,术后两组Berg平衡量表评分与起立行走计时测试评分的时间效应、交互效应、组间效应均具有统计学意义（F_时间=1 645.43,F_交互=73.51,F_组间=761.72;F_时间=4 289.34,F_交互=72.83,F_组间=231.43,均P<0.05）。非参数检验结果显示,两组术后4周、8周的中文版跌倒效能量表评分比较,差异均有统计学意义（Z=-4.09,P<0.001;Z=-2.65,P<0.01）。 结论 渐进式平衡训练方案可加速全髋关节置换术后患者康复早期平衡能力、行走能力的恢复,提高患者跌倒效能,改善患者害怕跌倒的心理。

关键词: 关节成形术, 置换, 髋, 姿势平衡, 渐进式训练, 康复护理