| 摘要: |
| ［摘要］ 目的 观察神经肌肉电刺激联合程序化下肢训练在老年股骨转子间骨折患者中的应用效果。方法 招募2019年1月至2021年9月于首都医科大学附属北京康复医院接受手术治疗的老年股骨转子间骨折患者86例，采用随机数字表法将其分为对照组和观察组，每组43例。对照组接受常规康复治疗。观察组在常规康复治疗基础上增加神经肌肉电刺激联合程序化下肢训练。比较两组骨折愈合情况、并发症发生情况、骨代谢指标、运动功能恢复情况以及生活质量。结果 观察组骨折愈合时间、离床时间、部分负重时间及完全负重时间短于对照组，差异有统计学意义（P<0.05）。观察组术后并发症发生率显著低于对照组（4.65% vs 18.60%； χ2=4.074，P=0.044）。在术后1周、3个月和6个月，观察组视觉模拟量表（VAS）评分低于对照组，Harris评分和Barthel指数（BI）评分高于对照组，差异有统计学意义（P<0.05）。在术后3个月和6个月，观察组骨钙素（OC）和Ⅰ型前胶原氨基端前肽（PINP）水平高于对照组，Ⅰ型胶原羧基端交联肽（CTX）水平低于对照组，差异有统计学意义（P<0.05）。结论 神经肌肉电刺激联合程序化下肢训练有助于促进老年股骨转子间骨折患者术后骨折愈合和运动功能恢复，减少并发症发生，改善生活质量，其作用机制可能与骨代谢指标调节有关。 |
| 关键词: 神经肌肉电刺激 程序化下肢训练 股骨转子间骨折 老年患者 运动功能 骨代谢 |
| DOI：10.3969/j.issn.1674-3806.2023.10.11 |
| 分类号:R 493 |
| 基金项目:国家重点研发计划课题（编号：2020YFC2004303） |
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| Observation on the application effect of neuromuscular electrical stimulation combined with programmed lower limb rehabilitation training in elderly patients with intertrochanteric fracture of femur |
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LI Wei, WANG Ye, LI Nan, et al.
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Department of Rehabilitation Diagnosis and Treatment, Beijing Rehabilitation Hospital, Capital Medical University, Beijing 100144, China
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| Abstract: |
| ［Abstract］ Objective To observe the application effect of neuromuscular electrical stimulation combined with programmed lower limb rehabilitation training in elderly patients with intertrochanteric fracture of femur. Methods Eighty-six elderly patients with intertrochanteric fracture of femur who received surgical treatment in Beijing Rehabilitation Hospital, Capital Medical University from January 2019 to September 2021 were recruited and divided into control group and observation group by random number table method, with 43 cases in each group. The control group received routine rehabilitation treatment, while the observation group received additional neuromuscular electrical stimulation combined with programmed lower limb rehabilitation training on the basis of routine rehabilitation treatment. Fracture healing, complications, bone metabolic markers, motor function recovery and quality of life were compared between the two groups. Results The fracture healing time, time getting out of bed, partial weight-bearing time and full weight-bearing time in the observation group were shorter than those in the control group, and the differences were statistically significant(P<0.05). The incidence of postoperative complications in the observation group was significantly lower than that in the control group(4.65% vs 18.60%; χ2=4.074, P=0.044). At 1 week, 3 months and 6 months after surgery, the Visual Analogue Scale(VAS) scores in the observation group were lower than those in the control group, and the Harris scores and Barthel index(BI) scores in the observation group were higher than those in the control group, and the differences were statistically significant(P<0.05). At 3 and 6 months after surgery, the levels of osteocalcin(OC) and amino-terminal propeptide of type Ⅰ precollagen(PINP) in the observation group were higher than those in the control group, and the level of C-terminal telopeptide of type Ⅰ collagen(CTX) in the observation group was lower than that in the control group, and the differences were statistically significant(P<0.05). Conclusion Neuromuscular electrical stimulation combined with programmed lower limb rehabilitation training can help to promote fracture healing and motor function recovery in elderly patients with intertrochanteric fracture of femur after surgery, reduce complications and improve quality of life. The mechanisms of these actions may be related to the regulation of bone metabolic markers. |
| Key words: Neuromuscular electrical stimulation Programmed lower limb rehabilitation training Intertrochanteric fracture of femur Elderly patient Motor function Bone metabolism |
