关键词:

股骨颈骨折, 运动功能评估, 个体化康复锻炼, 髋关节功能, 功能恢复

Abstract:

Objective　To observe the effect of individualized rehabilitation exercise guided by motor function evaluation on postoperative functional rehabilitation of patients with femoral neck fractures. Methods　This was a prospective study. One hundred and twenty-three patients with femoral neck fractures treated at First Hospital, Nanyang Medical College from June 2019 to January 2022 were selected as the research objects. The patients were divided into an observation group (62 cases) and a control group (61 cases) by lottery. There were 31 men and 30 women in the control group; they were (52.33±0.15) years old. There were 32 men and 30 women in the observation group; they were (52.47 ± 0.11) years old. The control group implemented routine rehabilitation management, and the observation group did individualized rehabilitation exercise under the guidance of motor function evaluation based on Fugl-Meyer Motor Function Scale (FMA). The hip joint activities of the two groups before and after the intervention were compared. The patients were followed up for 8 months after the intervention. The scores of Harris Hip Joint Scoring (Harris) and Visual Analogue Scale (VAS) at 1, 4, and 8 months of the intervention were compared between the two groups. The adverse events of the two groups during the follow-up period were compared. χ² and t test were applied. Results　After the intervention, the ranges of extending, bending, and inward rotation of their hip joints in the observation group were bigger than those in the control group [(33.72±0.85)° vs. (33.41±0.22)°, (133.66±0.83)° vs. (133.35±0.27)°, (30.55±0.81)° vs. (30.21±0.16)°], with statistical differences (t=2.759, 2.776, and 3.217; all P<0.05). During the follow up, the Harris scores at 1, 4, and 8 months of the intervention in the observation group were higher than those in the control group [(68.77±0.82) vs. (68.42±0.16), (72.65±0.83) vs. (72.33±0.21), and (85.59±0.82) vs. (85.25±0.27)], with statistical differences (t=3.273, 2.920, and 3.078; all P<0.05). The scores of VAS at 1, 4, and 8 months of the intervention in the observation group were lower than those in the control group [(4.11±0.25) vs. (4.42±0.83), (3.36±0.25) vs. (3.68±0.85), and (2.77±0.21) vs. (3.04±0.88)], with statistical differences (t=2.814, 2.842, and 2.349; P<0.05). During the follow up, the incidence of adverse events in the observation group was lower than that in the control group [4.84% (3/62) vs. 16.39% (10/61)], with a statistical difference (χ²=7.030, P<0.05). Conclusion　The implementation of individualized rehabilitation exercise based on the comprehensive evaluation of the lower limb motor function by FMA in patients with femoral neck fractures can significantly improve their recovery of hip joint range of motion and joint function, alleviate their hip joint pain, and reduce the risk of adverse events.

Key words:

Femoral neck fractures, Motor function evaluation, Individual rehabilitation exercise, Hip joint function, Functional rehabilitation