骨质疏松椎体压缩性骨折患者运动方案的构建 [中文引用][英文引用]

目的 构建骨质疏松椎体压缩性骨折患者康复运动方案。方法 采用计算机检索中英文数据库和网站，收集关于骨质疏松椎体压缩性骨折患者康复运动相关文献；由两名经过循证护理学系统培训的研究者独立筛选文献，对文献质量进行评价，提取相关证据，并对 15 例处于不同阶段的骨质疏松椎体压缩性骨折患者进行康复运动需求的半结构化访谈，初步形成运动方案；应用德尔菲法进一步验证该运动方案的科学性和可行性。结果 本研究制定的涵盖骨质疏松椎体压缩性骨折患者术前、术后卧床期间、术后离床活动期间（术后第 1 周）、术后第 2~8 周、第 9~12 周运动方案，包括运动方式、运动项目、运动时间、运动频率、运动强度、运动安全 6 个方面。2 轮专家函询的问卷回收率和有效率均为 100.00%，函询专家的权威系数为 0.94，2轮函询的肯德尔和谐系数 W 分别为 0.184、0.334，具有统计学意义（均 P<0.001）。结论 本研究构建的骨质疏松椎体压缩性骨折患者运动方案具有科学性、可靠性及合理性，充分考虑了患者康复过程的连续性与阶段性特征，可为临床医护人员指导患者康复运动提供依据。

Objective To develop a rehabilitation exercise program for the patients with osteoporotic vertebral compression fractures. Methods An online search was performed across both Chinese and English databases and websites to retrieve literature on rehabilitation exercises and related therapeutic measures for patients with osteoporotic vertebral compression fractures. Two researchers independently screened the retrieved literature, evaluated the quality, and extracted relevant evidence. Semi-structured interviews were conducted among 15 patients at various rehabilitation phases about the requirements of rehabilitation. A preliminary exercise program was developed and verified for the validity and feasibility using Delphi method. Results A rehabilitation exercise program was formulated. The program included five periods of preoperative period, bedridden period after surgery, ambulation period（1 week after surgery）, weeks 2-8 after surgery and weeks 9-12 after surgery covering six domains of exercise type, exercise items, exercise duration, exercise frequency, exercise intensity and exercise safety. The response rate and effective rate over the two rounds of expert consultation were both 100.00%, with an authority coefficient of 0.94. The Kendall’s W coefficients for secondary indicators in the two rounds of expert consultation were 0.184 and 0.334, respectively（both P<0.001）. Conclusion The exercise program developed in this study for the patients with osteoporotic vertebral compression fractures is scientifically reliable and reasonable. The two features of continuity and staged characteristics in rehabilitation process are fully considered, thereby it offers a guidance for clinical healthcare professionals as well as the patients in development of practical and effective rehabilitation exercise plans.