Muscle fatigue in arthritis total hip replacement

关节炎全髋关节置换术中的肌肉疲劳

• 批准号: 6356335
• 负责人: GINA E. BERTOCCI
• 金额: $ 11.42万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-09-25 至 2001-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6356335
• 关键词: biomechanics; clinical research; electromyography; exercise; fatigue; functional ability; hip prosthesis; human subject; medical rehabilitation related tag; muscle strength; osteoarthritis; postoperative state; rehabilitation

Background: More than 124,000 total hip replacement (THR) surgeries are performed annually in the US in an effort to increase mobility and comfort in those having arthritic, deteriorated or injured hips. The most common preoperative diagnosis for THR is osteoarthritis. As indicated in the NIH Total Hip Replacement Consensus Conference, questions remain concerning rehabilitation approaches which yield the best long-term outcomes. No previous investigations regarding the influence of muscle fatigue in THR patients have been identified. Muscle fatigue and endurance can significantly affect mobility1 function and the risk of secondary injury in this patient population. Aim/Hypothesis: This study seeks to evaluate muscle fatigue in arthritis patients who have undergone total hip replacement (THR) surgery as a means to assess rehabilitation status. The primary hypothesis of our study is that THR patients exhibit increased rates and levels of fatigue placing this population at higher risk for falls, joint dislocations and other injuries. Should this hypothesis prove conclusive, rehabilitation evaluation and training strategies should be expanded to address endurance. Methods. A combination of EMG measures and joint kinetic analysis will be utilized to assess THR patient response to mild muscle fatigue. Test conditions will include dynamometer submaximal (80% MVC) isometric and isokinetic exercises. Response of the patient group's operated hip will be compared to the unoperated hip, as well as to a control group. THR subjects will be assessed postoperatively between 4 and 5 months. Self-assessment of physical and social function will also be evaluated using the MOSS-SF 36, HAQ and MAQ. Preliminary Results/Findings: Our preliminary data from a pilot study (10 cases and 10 controls) funded by the Western Pa. Chapter of the Arthritis Foundation indicates that differences exist between cases and controls in muscle fatigue/endurance and self-assessed physical and social function. Across all biomechanical measures THR cases have lower performance or outcome. Statistically significant differences were found between cases and controls in isokinetic performance associated with hip flexion, extension and abduction. Cases also differed significantly from controls in the level of muscle fatigue associated with 80% MVC exercises as measured by median bower frequency shift. We further observed lower isokinetic performance in case operated hips than unoperated hips. Significant differences were found between operated and unoperated isokinetic performance in hip flexion. Self-assessment of THR cases as measured using the MOSS-SF36 was also consistent lower than that of control subjects.

背景：美国每年进行超过 124,000 例全髋关节置换 (THR) 手术，旨在提高患有关节炎、髋关节恶化或受伤的患者的活动能力和舒适度。 THR 最常见的术前诊断是骨关节炎。正如 NIH 全髋关节置换共识会议所指出的，关于能产生最佳长期结果的康复方法仍然存在疑问。之前没有关于 THR 患者肌肉疲劳影响的研究。肌肉疲劳和耐力会显着影响该患者群体的活动能力和继发性损伤的风险。目的/假设：本研究旨在评估接受全髋关节置换（THR）手术的关节炎患者的肌肉疲劳，作为评估康复状态的一种手段。我们研究的主要假设是，THR 患者的疲劳率和疲劳程度增加，使该人群跌倒、关节脱位和其他损伤的风险更高。如果这一假设得到证实，则应扩大康复评估和训练策略以解决耐力问题。方法。 将结合肌电图测量和关节动力学分析来评估 THR 患者对轻度肌肉疲劳的反应。测试条件将包括测功机次最大 (80% MVC) 等长和等速练习。患者组接受手术的髋关节的反应将与未接受手术的髋关节以及对照组进行比较。 THR 受试者将在术后 4 至 5 个月内接受评估。身体和社会功能的自我评估也将使用 MOSS-SF 36、HAQ 和 MAQ 进行评估。初步结果/调查结果：我们来自关节炎基金会西宾夕法尼亚州分会资助的一项试点研究（10 个病例和 10 个对照）的初步数据表明，病例和对照在肌肉疲劳/耐力以及自我评估的身体和社交方面存在差异功能。在所有生物力学指标中，THR 病例的表现或结果较低。在与髋关节屈曲、伸展和外展相关的等速表现方面，病例和对照之间发现了统计学上的显着差异。通过中位鲍尔频移测量，与 80% MVC 练习相关的肌肉疲劳水平与对照组也存在显着差异。我们进一步观察到手术髋关节的等速性能低于未手术髋关节。在髋关节屈曲方面，手术和未手术的等速性能存在显着差异。使用 MOSS-SF36 测量的 THR 病例的自我评估也始终低于对照受试者。