The effect of quantitative rehabilitation training guided by the concept of empowerment on postoperative rehabilitation in patients with osteoporotic hip fracture
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摘要:
目的 探讨赋能理念指导的量化康复训练对骨质疏松性髋部骨折患者术后康复的影响,旨在为患者术后快速康复提供借鉴。 方法 收集2022年6月—2024年6月在武汉市第一医院进行全髋置换术治疗的120例骨质疏松性髋部骨折患者相关资料,按干预方法不同进行分组,其中对照组(57例)行量化康复训练,研究组(63例)在此基础上给予基于赋能理念的康复训练指导。比较2组恐惧回避信念、自我效能、髋关节功能及生活质量。 结果 干预后研究组体力活动、工作恐惧回避信念评分分别为(11.07±3.12)分、(20.88±4.82)分,均低于对照组的(17.21±3.64)分、(31.84±5.39)分(F=787.801、931.311,P<0.001);应对、身体锻炼自我效能评分分别为(44.62±4.39)分、(42.83±3.05)分,均高于对照组的(36.17±6.01)分、(35.11±3.81)分(F=701.077、974.633,P<0.001);髋关节功能各维度评分高于对照组(P<0.05);生活质量各维度评分高于对照组(P<0.05)。 结论 赋能理念指导的量化康复训练可明显降低骨质疏松性髋部骨折患者全髋置换术后恐惧回避信念,促进关节功能康复。 Abstract:Objective To explore the effects of quantitative rehabilitation training guided by the concept of empowerment on the postoperative rehabilitation of patients with osteoporotic hip fracture, in order to provide reference for patients with rapid postoperative rehabilitation. Methods The relevant data of 120 patients with osteoporotic hip fracture who underwent total hip arthroplosty in Wuhan First hospital from June 2022 to June 2024 were collected and divided into the control group (n=57, quantitative rehabilitation training) and the study group (n=63, quantitative rehabilitation training + rehabilitation training guidance based on the concept of empowerment) according to different intervention method. Fear-avoidance belief, self-efficacy, hip function, and quality of life were compared between the two groups. Results After intervention, the study group had lower scores of physical activity and work-fear avoidance belief than the other group [(11.07±3.12) points and (20.88±4.82) points vs. (17.21±3.64) points and (31.84±5.39) points, F=787.801, 931.311, P<0.001], while higher scores of coping and physical exercise self-efficacy [(44.62±4.39) points and (42.83±3.05) points vs. (36.17±6.01) points and (35.11±3.81) points, F=701.077, 974.633, P<0.001]; The scores of hip joint function in the study group were higher, and the scores of quality of life were also higher (P<0.05). Conclusion Quantitative rehabilitation training guided by the concept of empowerment can significantly reduce the fear avoidance belief of patients with osteoporotic hip fracture after total hip arthroplosty, and promote the rehabilitation of joint function. -
Key words:
- Hip fracture /
- Osteoporosis /
- Total hip replacement /
- Empowerment /
- Rehabilitation training
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表 1 2组骨质疏松性髋部骨折患者基线资料比较
Table 1. Comparison of baseline data between two groups of patients with osteoporotic hip fractures
组别 例数 性别
(男性/女性,例)年龄
(x±s,岁)骨折类型(股骨颈骨折/股骨转子间骨折,例) 患侧
(左/右,例)学历(高中及以下/中专及以上,例) 研究组 63 36/27 71.69±2.85 38/25 34/29 44/19 对照组 57 31/26 72.14±3.01 37/20 32/25 43/14 统计量 0.092a 0.841b 0.270a 0.057a 0.470a P值 0.761 0.402 0.604 0.811 0.493 注:a为χ2值,b为t值。 表 2 2组骨质疏松性髋部骨折患者恐惧回避信念比较(x±s,分)
Table 2. Comparison of fear avoidance beliefs between two groups of patients with osteoporotic hip fractures(x±s, points)
组别 例数 体力活动恐惧回避 t值 P值 工作恐惧回避信念 t值 P值 干预前 干预后 干预前 干预后 研究组 63 23.86±2.71 11.07±3.12 34.826 <0.001 47.15±5.41 20.88±4.82 40.765 <0.001 对照组 57 24.19±2.51 17.21±3.64 17.138 <0.001 46.79±6.17 31.84±5.39 19.528 <0.001 统计量 0.682a 787.801b 0.337a 931.311b P值 0.493 <0.001 0.735 <0.001 注:a为t值,b为F值。 表 3 2组骨质疏松性髋部骨折患者自我效能比较(x±s,分)
Table 3. Comparison of self-efficacy between two groups of patients with osteoporotic hip fractures(x±s, points)
组别 例数 应对自我效能 t值 P值 身体锻炼自我效能 t值 P值 干预前 干预后 干预前 干预后 研究组 63 31.06±7.18 44.62±4.39 -18.605 <0.001 20.14±5.21 42.83±3.05 -43.607 <0.001 对照组 57 30.85±7.69 36.17±6.01 -5.864 <0.001 20.73±4.98 35.11±3.81 -24.702 <0.001 统计量 0.153a 701.077b 0.626a 974.633b P值 0.878 <0.001 0.529 <0.001 注:a为t值,b为F值。 表 4 2组骨质疏松性髋部骨折患者髋关节功能比较(x±s,分)
Table 4. Comparison of hip joint function between two groups of patients with osteoporotic hip fractures(x±s, points)
组别 例数 畸形 t值 P值 活动范围 t值 P值 关节功能 t值 P值 疼痛 t值 P值 干预前 干预后 干预前 干预后 干预前 干预后 干预前 干预后 研究组 63 1.71±0.42 3.32±0.60 -25.057 <0.001 2.29±0.56 4.06±0.38 -29.891 <0.001 9.18±2.36 38.04±4.13 -70.591 <0.001 12.59±3.28 40.46±1.77 -87.608 <0.001 对照组 57 1.68±0.44 2.81±0.71 -14.837 <0.001 2.31±0.55 3.61±0.47 -19.245 <0.001 9.27±2.29 32.25±5.11 -46.891 <0.001 13.01±3.05 36.88±2.25 -68.005 <0.001 统计量 0.378a 337.629b 0.195a 458.646b 0.210a 542.836b 0.716a 770.852b P值 0.704 <0.001 0.845 <0.001 0.834 <0.001 0.471 <0.001 注:a为t值,b为F值。 表 5 2组骨质疏松性髋部骨折患者生活质量比较(x±s,分)
Table 5. Comparison of the quality of life between two groups of patients with osteoporotic hip fractures(x±s, points)
组别 例数 物质生活状态 t值 P值 躯体功能 t值 P值 心理功能 t值 P值 社会功能 t值 P值 干预前 干预后 干预前 干预后 干预前 干预后 干预前 干预后 研究组 63 46.31±5.19 68.35±6.42 -30.136 <0.001 45.94±6.41 65.89±8.62 -21.071 <0.001 42.31±5.82 68.38±8.21 -29.497 <0.001 44.42±5.88 67.41±7.61 -27.054 <0.001 对照组 57 46.99±5.04 63.66±5.68 -23.481 <0.001 46.55±6.69 59.83±9.05 -12.740 <0.001 41.84±6.03 62.34±7.09 -23.593 <0.001 44.96±5.60 61.38±6.11 -21.173 <0.001 统计量 0.719a 334.223b 0.504a 297.475b 0.429a 339.926b 0.508a 376.516b P值 0.470 <0.001 0.612 <0.001 0.666 <0.001 0.609 <0.001 注:a为t值,b为F值。 -
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