早期稳定性康复锻炼方案对老年腰椎退行性疾病手术患者康复效果的影响 [中文引用][英文引用]

目的  探讨早期稳定性康复锻炼方案在老年腰椎退行性疾病手术患者中的应用效果，为患者术后康复提供有效的指导。方法  采用便利抽样法，2023 年 2 月— 2024 年 5 月选取某三级甲等综合医院 121 例骨科患者作为研究对象，按照随机数字法分为对照组 61 例和干预组 60 例。对照组患者术后给予常规护理与康复，干预组患者术后在对照组基础上实施 2w的早期稳定性康复锻炼方案。比较两组患者术前 1d 或 3d、术后 2w、术后 4w 腰椎功能与日常生活自理能力和疼痛程度。结果  干预组患者在术后 2w 和术后 4w 的腰椎功能评分高于对照组，术后 3d、术后 2w 和 4w 疼痛评分低于对照组，日常生活自理能力评分高于对照组，两组比较，差异具有统计学意义（均 P<0.05）。重复测量方差分析显示，两组患者的腰椎功能评分、疼痛评分、日常生活自理能力评分在不同时间点的时间主效应、组间主效应和交互效应均有统计学意义（均 P<0.001）。结论  早期稳定性康复锻炼方案能够在保证患者安全的前提下，改善老年腰椎退行性疾病患者术后腰椎功能、疼痛程度及日常生活自理能力。

Objective To investigate the effect of early stability rehabilitation exercises in elderly patients after the surgery fordegenerative lumbar disease and to provide effective guidance for the postoperative rehabilitation. Methods From February 2023 toMay 2024，a convenience sampling method was used to select 121 patients who received surgery for degenerative lumbar disease in ourhospital as the study subjects. The patients were randomly divided into two groups with a random number table：a control group（n=61）andan intervention group（n=60）. Patients in the control group received routine nursing care and rehabilitation exercises，while the patientsin the intervention group received 2 weeks of early stability rehabilitation exercises on top of the control group. Lumbar spine function，daily living self-care ability and score of pain were recorded and compared between the two groups on day 1 or day 3 before surgery and at2 weeks and 4 weeks after surgery. Results JOA scores of the intervention group were found higher than those of the control group at 2 and 4 weeks after surgery，all with significant differences between the groups（P<0.05）. VAS scores of the intervention group were lowerthan those of the control group at 3 days，2 weeks，and 4 weeks after surgery，all with significant differences（P<0.05）. Scores for dailyliving self-care ability of the intervention group were higher than those of the control group at 2 weeks and 4 weeks after surgery，all withsignificant differences（P<0.05）. The repeated measures analysis of variance showed that the time main effect and inter group main effectof JOA score，VAS score and self-care ability score in daily life of different time all showed statistical significance between the groups（allP<0.001）. Conclusion An early stability rehabilitation exercise can improve the postoperative lumbar function，pains，and self-careability in daily life in elderly patients after the surgery for degenerative lumbar diseases，as well as accelerate the postoperative recovery，while ensuring the safety of patients.