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

摘要：

目的　观察运动功能评估指导下的个体化康复锻炼在股骨颈骨折术后应用效果及对患者术后功能康复的影响。方法　本文为前瞻性研究，选取南阳医学高等专科学校第一附属医院2019年6月至2022年1月期间的123例股骨颈骨折患者为研究对象，采用抽签法，将入组患者分为观察组和对照组。对照组61例，男31例、女30例，年龄（52.33±0.15）岁，仅实施常规康复管理；观察组62例，男32例、女30例，年龄（52.47±0.11）岁，实施基于Fugl-Meyer 运动功能评分量表（FMA）运动功能评估指导下的个体化康复锻炼。比较两组患者干预前后的髋关节活动度，于干预结束后对患者开展为期8个月的短期随访，比较两组患者干预1、4、8个月时的Harris 髋关节功能评分（Harris评分）、视觉模拟疼痛（VAS）评分变化情况，比较两组随访期间的不良事件发生情况。统计学方法采用χ²检验、t检验。结果　干预后，观察组的髋关节外展、屈曲、内旋均大于对照组［（33.72±0.85）°比（33.41±0.22）°、（133.66±0.83）°比（133.35±0.27）°、（30.55±0.81）°比（30.21±0.16）°］，差异均有统计学意义（t=2.759、2.776、3.217，均P<0.05）；随访期间，观察组干预1、4、8个月时的Harris评分均高于对照组［（68.77±0.82）分比（68.42±0.16）分、（72.65±0.83）分比（72.33±0.21）分、（85.59±0.82）分比（85.25±0.27）分］，差异均有统计学意义（t=3.273、2.920、3.078，均P<0.05）；观察组干预1、4、8个月时的VAS评分均低于对照组［（4.11±0.25）分比（4.42±0.83）分、（3.36±0.25）分比（3.68±0.85）分、（2.77±0.21）分比（3.04±0.88）分］，差异均有统计学意义（t=2.814、2.842、2.349，均P<0.05）；随访期间，观察组的不良事件发生率为4.84%（3/62），低于对照组［16.39%（10/61）］，差异有统计学意义（χ²=7.030，P<0.05）。结论　基于FMA量表对股骨颈骨折患者下肢运动功能进行综合评估后实施个体化康复锻炼可显著促进髋关节活动度恢复、改善髋关节功能、缓解髋关节疼痛并降低不良事件发生风险。

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