目的 探讨腰椎后路减压内固定术后腰背肌锻炼最佳开始时间，以及对患者康复结局和运动恐惧的影响。 方法 采用随机对照试验，以便利抽样法选取2020年2月至2021年12月上海大学附属南通医院（南通市第六人民医院）收治的120例腰椎间盘突出症患者为研究对象，按照入院时间分为早期锻炼组、中期锻炼组和后期锻炼组各40例。3组患者均给予常规术后护理；早期锻炼组从术后第10天开始腰背肌锻炼，中期锻炼组从术后第3周开始腰背肌锻炼，后期锻炼组从术后第6周开始腰背肌锻炼。采用日本骨科协会评分（JOA）、恐动症评分量表（TSK）评价干预效果。 结果 早、中、后期锻炼组分别有3、1、1例失访，3组患者年龄分别为（56.05 ± 11.77）、（57.33 ± 14.64）、（54.23 ± 15.73）岁。开始锻炼后3个月早、中、后期锻炼组的JOA总分分别为（25.32 ± 2.45）、（24.44 ± 2.19）、（22.13 ± 1.58）分，差异有统计学意义（F=23.64，P<0.05）。开始锻炼后3个月早、中、后期锻炼组的TSK评分分别为（37.95 ± 6.81）、（34.18 ± 6.39）、（33.33 ± 7.36）分，差异有统计学意义（F=4.82，P<0.05）。 结论 腰椎后路减压内固定术后第3周开始腰背肌锻炼，既能明显改善腰间盘突出症患者康复结局，又不会增加运动恐惧水平，可作为术后腰背肌锻炼最佳开始时间。 Objective To explore the optimum opportunity for lumbodorsal muscles exercises of patients undergoing posterior lumbar decompression and instrumentation, and investigate its effect on the rehabilitation outcomes and kinesiophobia. Methods A randomized controlled trial was used. By convenient sampling method, a total of 120 lumbar disc herniation patients were prospectively selected from Affiliated Nantong Hospital of Shanghai(Nantong Sixth People′s Hospital) from February 2020 to December 2021. The paitients were assigned to early group, middle group and late group, with 40 cases in each group. All patients were given routine postoperative care and lumbodorsal muscles exercises. The early group started to exercise 10th day after operation, the middle group started to exercise 3 weeks after operation, and the late group started to exercise 6 weeks after operation. The intervention effect was respectively evaluated by Japanese Orthopaedics Association (JOA) and Tampa Scale for Kinesiophobia (TSK). Results There were 3, 1 and 1 missing cases in the early, middle and late group respectively, the age in the 3 groups were (56.05 ± 11.77), (57.33 ± 14.64) and (54.23 ± 15.73) years old in turn. Three months after exercising, the total score of JOA in the early, middle and late group were (25.32 ± 2.45), (24.44 ± 2.19) and (22.13 ± 1.58) in turn, the difference was significant (F=23.64, P<0.05) the score of TSK in the early, middle and late group were (37.95 ± 6.81), (34.18 ± 6.39) and (33.33 ± 7.36) in turn, the difference was significant (F=4.82, P<0.05). Conclusions Lumbodorsal muscles exercises start at 3 weeks after operation can significantly improve the rehabilitation outcome of lumbar disc herniation patients undergoing posterior lumbar decompression and instrumentation, and will not increase the level of kinesiophobia, its can be consider as optimum opportunity for lumbodorsal muscles exercises.
Study on the optimal starting time for lumbodorsal muscles exercises of patients undergoing posterior lumbar decompression and instrumentation
Objective To explore the optimum opportunity for lumbodorsal muscles exercises of patients undergoing posterior lumbar decompression and instrumentation, and investigate its effect on the rehabilitation outcomes and kinesiophobia. Methods A randomized controlled trial was used. By convenient sampling method, a total of 120 lumbar disc herniation patients were prospectively selected from Affiliated Nantong Hospital of Shanghai(Nantong Sixth People′s Hospital) from February 2020 to December 2021. The paitients were assigned to early group, middle group and late group, with 40 cases in each group. All patients were given routine postoperative care and lumbodorsal muscles exercises. The early group started to exercise 10th day after operation, the middle group started to exercise 3 weeks after operation, and the late group started to exercise 6 weeks after operation. The intervention effect was respectively evaluated by Japanese Orthopaedics Association (JOA) and Tampa Scale for Kinesiophobia (TSK). Results There were 3, 1 and 1 missing cases in the early, middle and late group respectively, the age in the 3 groups were (56.05 ± 11.77), (57.33 ± 14.64) and (54.23 ± 15.73) years old in turn. Three months after exercising, the total score of JOA in the early, middle and late group were (25.32 ± 2.45), (24.44 ± 2.19) and (22.13 ± 1.58) in turn, the difference was significant (F=23.64, P<0.05) the score of TSK in the early, middle and late group were (37.95 ± 6.81), (34.18 ± 6.39) and (33.33 ± 7.36) in turn, the difference was significant (F=4.82, P<0.05). Conclusions Lumbodorsal muscles exercises start at 3 weeks after operation can significantly improve the rehabilitation outcome of lumbar disc herniation patients undergoing posterior lumbar decompression and instrumentation, and will not increase the level of kinesiophobia, its can be consider as optimum opportunity for lumbodorsal muscles exercises.
万方数据
