Incorporating Specific Functional Strength Integration Techniques to Improve Functional Performance for Veterans After Total Hip Arthroplasty: Protocol for a Randomized Clinical Trial.
Incorporating Specific Functional Strength Integration Techniques to Improve Functional Performance for Veterans After Total Hip Arthroplasty: Protocol for a Randomized Clinical Trial.
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结合特定的功能力量整合技术来提高退伍军人全髋关节置换术后的功能表现：随机临床试验方案。
DOI：
10.1093/ptj/pzz109
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发表时间：
2019
期刊：
影响因子：
3.2
通讯作者：
Stevens-Lapsley,JenniferE
中科院分区：
文献类型：
--
作者：
Judd,DanaL;Cheuy,VictorA;Forster,JeriE;Christiansen,CoryL;Stevens-Lapsley,JenniferE
研究背景全髋关节置换术（THA）是一种常见的手术，但术后存在持续的功能缺陷。这些缺陷可能与THA后观察到的运动补偿有关，这对生活质量产生负面影响，并可能增加发病率和医疗保健利用率，包括退伍军人。然而，尚未确定补救运动补偿和身体功能缺陷的最佳康复方法。目的是确定作为THA后康复计划的一部分，功能性力量整合干预（FSI）是否改善了运动补偿、身体功能、肌肉力量，和自我报告的结果措施超过对照组（CON）进行标准的护理锻炼计划。设计这是一个2臂随机，对照临床试验。设置退伍军人事务部门诊物理治疗诊所和学术研究实验室将是设置。研究对象将包括100名因髋关节骨关节炎接受THA的退伍军人。干预措施参与者将被随机分配到FSI组或CON组，参加为期8周的物理治疗访问。FSI方案将包括有针对性的运动，以改善髋关节和躯干周围的肌肉控制和稳定性，以最大限度地减少日常活动期间的运动补偿，并结合渐进式阻力运动。CON方案将包括患者教育、灵活性活动和低负荷阻力运动。测量功能表现、肌肉力量和耐力以及自我报告的结果将在基线时测量（手术前），干预中途（手术后6周），干预结束时（手术后10周），局限性无法盲目治疗治疗师研究手臂分配是一个局限性。结论拟议的研究旨在确定是否有针对性的FSI可以影响运动与传统康复模式相比，THA后补偿改善功能结果的作用更大。
BackgroundTotal hip arthroplasty (THA) is a common procedure, yet persistent deficits in functional performance exist after surgery. These deficits may be related to movement compensations observed after THA, which negatively affect quality of life and may increase morbidity and health care utilization, including in the veteran population. However, the best rehabilitative approach to remediating movement compensations and physical function deficits has not been determined.ObjectiveThe objective is to determine if a functional strength integration intervention (FSI), as part of a post-THA rehabilitation program, improves movement compensation, physical function, muscle strength, and self-reported outcome measures more than a control group (CON) undergoing a standard of care exercise program.DesignThis is a 2-arm randomized, controlled clinical trial.SettingThe Veteran Affairs outpatient physical therapy clinics and academic research laboratory will be the settings.ParticipantsOne hundred veterans undergoing THA for hip osteoarthritis will be included in the study.InterventionsParticipants will be randomized to either the FSI or CON group and participate in visits of physical therapy over 8 weeks. The FSI protocol will include targeted exercise to improve muscular control and stability around the hip and trunk to minimize movement compensation during daily activity combined with progressive resistance exercise. The CON protocol will include patient education, flexibility activity, and low load resistance exercise.MeasurementsFunctional performance, muscle strength and endurance, and self-reported outcomes will be measured at baseline (prior to surgery), midway through intervention (6 weeks after surgery), at the end of intervention (10 weeks after surgery), and 26 weeks after THA.LimitationsThe inability to blind treating therapists to study arm allocation is a limitation.ConclusionsThe proposed study aims to determine if targeted FSI can affect movement compensation to improve functional outcomes after THA more than traditional rehabilitation paradigms.