Effects of Early Muscle Strengthening of Hip Abductor and Adductor Muscles after Surgery for Pelvic Fracture

[Purpose] The purpose of this study was to clarify the effects of muscle strengthening of hip abductor and adductor muscles just after surgery on gait at discharge. [Subjects and Methods] Subjects were twelve patients who had open reduction and internal fixation (ORIF) for unstable unilateral fractures of the pelvis. Six patients started muscle strengthening exercises at two weeks after surgery (regular rehabilitation group, RR), and another six patients started muscle strengthening of hip abductor and adductor muscles at two or three days after surgery (early rehabilitation group, ER). All patients were assessed for free gait without a cane when they were discharged from hospital. Gait analysis was performed using the VICON 370 system with six cameras and four force plates. [Results] Walking speed, step length and cadence showed no significant differences between the two groups. The hip abductor moment of the ER group was significantly higher than that of the RR group. [Conclusion] Our results suggest that early muscle strengthening of hip abductor and adductor muscles might improve hip abductor moment at discharge. [目的]本研究の目的は，術後早期から股関節内外転筋力強化運動を重点的に行うことで，退院時の歩容に影響があるかを明らかにすることとした。[方法]対象は2005年l月から2007年12月までの期間で骨盤骨折を受傷し，当院にて骨接合術を施行した12例とした。術後2週目より骨折側の筋力強化を開始した6例を標準リハ群，術後2-3日後より筋力強化を開始した6例を早期リハ群とした。全荷重可能となった退院時に三次元動作解折装置を用いて歩行解析を行い，群間における歩行速度，歩幅，ケイデンス，股関節外転モーメントを比較した。[結果]歩行速度，歩幅，ケイデンスは群間に有意差は見られなかったが，早期リハ群の立脚期股関節外転モーメントは標準リ八群と比較して有意に高値を示していた。[結語]本研究の結果より，術後早期からの股関節内外転筋力強化運動によって退院時の歩行能力が改善される可能性が示された