고관절 인공관절 전치환술 환자에서 자세균형의 변화
The Changes of Postural Balance in Patients with Total Hip Arthroplasty
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목적: Computerized dynamic posturography를 이용하여 고관절 인공관절 전치환술 전, 후의 자세균형조절 능력에 대한 변화 를 조사하였다. 대상 및 방법: 고관절 인공관절 전치환술을 시행 받은 18명의 환자에 대해 전향적 연구를 하였으며 수술 전과 수술 후 12개월 이상 경과한 후에 Computerized dynamic posturography를 이용해 감각체제 검사(SOT: sensory organization test)를 시행하 여 자세균형을 측정하였다. 임상 결과는 수술 전, 후의 Harris hip scoring systems을 통해 평가하였으며, 이 결과와 자세균형조 절과의 상관관계를 알아 보았다. 또한, 수술 전, 후의 평형점수를 비교하여 자세균형조절의 향상 및 영향을 주는 인자에 대해 조 사하였다. 결과: 고관절 인공관절 전치환술 후 고유수용감각에 의한 자세균형조절은 시각적 보상능력을 차단한 상태에서 통계적으로 의미 있게 높았으며(p<0.05), 또한 수술 전, 후의 Harris hip score의 증가와도 유의한 상관관계(correlation)를 보였다(p<0.01, r=0.649). 결론: 고관절 인공관절 전치환술을 시행 받은 환자에서 수술 전과 비교하여 동적 움직임시 고유수용감각의 회복에 의한 자세균 형조절 능력이 호전되었으며 Harris hip score와 같은 임상적 호전과도 상관관계를 보였다. 이는 인공관절 전치환술을 통해 통 증의 감소, 관절 기능회복 및 활동성의 증가 등과 이에 따른 자세균형조절의 향상이라는 긍정적인 효과를 확인하는 결과로 볼 수 있다
Abstract
Purpose: To investigate the changes in postural balance before and after total hip arthroplasty (THA) using computerized dynamic posturography Materials and Methods: This was a prospective study of 18 patients undergoing total hip arthroplasty. We evaluated each patient’s postural balance prior to, and at least 12 months after, total hip arthroplasty by using computerized dynamic posturography. We compared the preoperative equilibrium scores with the postoperative equilibrium scores. Clinical results were assessed for all patients preoperatively and postoperatively using the Harris hip scoring system. We investigated whether postural balance improves, and what factors were related to this parameter. Results: Patients showed significant improvement in postural balance by means of proprioception after total hip arthroplasty (p<0.05). We found, during intercepting visual compensation, that an increase in the Harris hip score was correlated with an improvement in balance (p<0.01, r = 0.649). Conclusion: Patients with Total hip arthroplasty showed improvement in dynamic postural balance through proprioceptive recovery, and balance improved as the Harris hip score increased. This resulted in decreased pain, recovery of articular function, enhancement of physical activity, and ultimately improvement in postural balance by means of total hip arthroplasty.
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