髋外展肌锻炼对非创伤性股骨头坏死患者三维步态及塌陷率的影响  

Effect of hip abductor muscle exercise on three-dimensional gait and collapse rate in patients with non-traumatic femoral head necrosis

作　　者：袁颖嘉 易艳梓 李津 王珂 王煜 林天烨 张庆文 何伟 魏秋实 Yuan Yingjia;Yi Yanzi;Li Jin;Wang Ke;Wang Yu;Lin Tianye;Zhang Qingwen;He Wei;Wei Qiushi(Third Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong Province,China;Guangdong Provincial Institute of Traditional Chinese Medicine Osteopathy,Guangzhou 510405,Guangdong Province,China;Third Clinical Medical College of Guangzhou University of Chinese Medicine,Guangzhou 510080,Guangdong Province,China)

机构地区：[1]广州中医药大学第三附属医院,广东省广州市510405 [2]广东省中医骨伤研究院,广东省广州市510405 [3]广州中医药大学第三临床医学院,广东省广州市510080

出　　处：《中国组织工程研究》2025年第33期7211-7216,共6页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金面上项目(82274544),项目负责人:魏秋实;广东省中医药管理局项目(20223012),项目负责人:张庆文;广东省中医药管理局项目(20233027),项目负责人:袁颖嘉。

摘　　要：背景:非创伤性股骨头坏死是一个疑难的关节疾病,保留自身的股骨头对于年轻的患者而言意义重大,目前尚缺乏规律、统一的保髋功能锻炼方案。目的:观察髋外展肌锻炼对非创伤性股骨头坏死患者三维步态及塌陷率的影响,为非创伤性股骨头坏死患者有效康复提供理论依据。方法:纳入2020年6月至2022年6月广州中医药大学第三附属医院收治的非创伤性、非手术性股骨头坏死患者81例81髋,随机将患者分为对照组(n=40)及髋外展肌锻炼组(n=41)。对照组接受常规物理治疗和药物治疗;髋外展肌锻炼组在对照组的基础上进行髋外展肌锻炼。治疗前及治疗后12周,采用Tecnobody平衡评估系统评估两组患者的步态情况(髋关节活动度、步长差值、触地时间差值);采用BIODEX-S4等速肌力测试系统测试髋外展等速肌力的力矩峰值;对比臀中肌宽度比。治疗后1年对比两组患者股骨头塌陷率的情况。结果与结论:①两组患者在年龄、性别、侧别、体质量指数、病因等方面相比差异均无显著性意义(P>0.05);②治疗前,两组患侧髋关节活动度对比无显著性差异(P>0.05);治疗后12周两组患者患侧髋关节活动度均较治疗前改善(P<0.05),且髋外展肌锻炼组患侧髋关节活动度显著大于对照组(P<0.05);③治疗前,两组患者步长差值、触地时间差值对比无显著性差异(P>0.05);治疗后12周两组步长差值、触地时间差值均较治疗前减小(P<0.05),且治疗后髋外展肌锻炼组步长差值、触地时间差值显著小于对照组(P<0.05);④治疗前,两组患者臀中肌宽度比对比无显著性差异(P>0.05);治疗后12周两组臀中肌宽度比均较治疗前增大(P<0.05),且治疗后髋外展肌锻炼组臀中肌宽度比显著大于对照组(P<0.05);⑤治疗后1年两组患者股骨头塌陷率对比差异有显著性意义(P<0.05),髋外展肌锻炼组(22%)显著小于对照组(45%);⑥提示髋外展肌锻炼可�BACKGROUND:Non-traumatic necrosis of the femoral head is a difficult joint disease,and preserving one’s own femoral head is of great significance for young patients.Currently,there is a lack of regular and unified functional exercise plans.OBJECTIVE:To investigate the effect of hip abductor muscle exercise on the three-dimensional gait and collapse rate of patients with non-traumatic femoral head necrosis,and to provide theoretical basis for effective rehabilitation of patients with non-traumatic femoral head necrosis.METHODS:Totally 81 non-traumatic and non-surgical patients with femoral head necrosis(81 hips)admitted to the Third Affiliated Hospital of Guangzhou University of Chinese Medicine from June 2020 to June 2022 were included.Patients were randomly divided into a control group(n=40)and a hip abductor muscle exercise group(n=41).The control group received routine physical therapy and medication treatment.The hip abductor muscle exercise group underwent hip abductor muscle exercise on the basis of the control group.The gait status(hip joint range of motion,step length difference,and ground contact time difference)of two groups of patients was evaluated using the Tecnobody balance assessment system before and 12 weeks after treatment.The BIODEX-S4 isokinetic muscle strength testing system was used to test the peak force distance of hip abduction isokinetic muscle strength.Gluteus medius width ratio was compared between two groups.The collapse rate was compared between two groups of patients 1 year after treatment.RESULTS AND CONCLUSION:(1)There was no statistically significant difference between the hip abductor muscle exercise group and the control group in terms of age,gender,side profile,body mass index,and etiology(P>0.05).(2)Before treatment,there was no significant statistical difference in the range of motion of the affected hip joint between the two groups(P>0.05).After treatment,the range of motion of the affected hip joint in both groups improved compared to before treatment(P<0.05),and the ran

关 键 词：股骨头坏死 髋外展肌 步态 功能锻炼 塌陷 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R681.8