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腰椎微切除术后动态腰椎稳定运动对疼痛、活动度和重返工作的影响。随机对照试验。

Effects of dynamic lumbar stabilization exercises following lumbar microdiscectomy on pain, mobility and return to work. Randomized controlled trial.

机构信息

Specialist in Physical Medicine and Rehabilitation Ankara Diskapi Yildirim Beyazit Education and Research Hospital Physical Medicine and Rehabilitation Clinic -

出版信息

Eur J Phys Rehabil Med. 2014 Dec;50(6):627-40. Epub 2014 Sep 9.

Abstract

BACKGROUND

Various lumbar exercise programs are prescribed for rehabilitation purposes following microdiscectomy applied for the treatment of lumbar disk herniation. The literature contains several studies on this subject. However, there are no studies investigating the effects of supervised dynamic lumbar stabilization exercises on fear and fear/regression attitudes of patients and on their return to work.

AIM

This study investigates the effects of supervised dynamic lumbar stabilization exercises during postoperative rehabilitation on spinal mobility, pain, functional status, return to work, quality of life, and fear/regression attitude of patients who underwent lumbar microdiscectomy for the first time.

SETTING

The study was conducted at physical therapy and rehabilitation clinics.

STUDY DESIGN

A randomized clinical trial comparing exercise programs after lumbar microdiscectomy.

PATIENTS SAMPLE

Forty-four lumbar microdiscectomy patients were randomized into two groups.

OUTCOME MEASURES

Each group was assessed in terms of low back pain, leg pain, spinal mobility, Oswestry Disability Index (ODI), and Nottingham Health Profile (NHP), at the postoperative first, second, and sixth months. Fear/regression beliefs and level of pain were evaluated through the Fear Avoidance Belief Questionnaire (FABQ).

METHODS

Forty-four patients were randomly divided into two equal groups of 22 subjects, respectively, as a study group with Dynamic Lumbar Stabilization (DLS) exercises and home exercises, and a control group with only home exercises for a period of four weeks.

RESULTS

Leg pain decreased more in the study group compared with the control group (P=0.004). Spinal mobility scores demonstrated greater increases in the study group (P<0.001). Statistically greater reductions were observed in the study group regarding ODI and FABQ scores (P<0.017).

CONCLUSION

DLS exercises may be recommended to patients following spinal surgery due to their benefits in reducing pain, increasing spinal mobility, and ensuring faster return to work periods.

摘要

背景

各种腰椎运动方案被用于腰椎间盘突出症微创术后的康复治疗。文献中有许多关于这个主题的研究。然而,没有研究调查监督下的动态腰椎稳定运动对患者的恐惧和恐惧/回避态度及其重返工作岗位的影响。

目的

本研究旨在调查术后康复期间监督下的动态腰椎稳定运动对首次接受腰椎微创手术的患者的脊柱活动度、疼痛、功能状态、重返工作岗位、生活质量和恐惧/回避态度的影响。

设置

该研究在物理治疗和康复诊所进行。

研究设计

比较腰椎微切除术后运动方案的随机临床试验。

患者样本

44 名腰椎微切除术后患者随机分为两组。

结果评估

每组在术后第一个、第二个和第六个月分别评估腰痛、腿痛、脊柱活动度、Oswestry 残疾指数(ODI)和诺丁汉健康状况量表(NHP)。恐惧/回避信念和疼痛程度通过恐惧回避信念问卷(FABQ)进行评估。

方法

44 名患者随机分为两组,每组 22 名患者,分别为接受动态腰椎稳定(DLS)运动和家庭运动的研究组和仅接受家庭运动 4 周的对照组。

结果

与对照组相比,研究组的腿痛减轻更多(P=0.004)。研究组的脊柱活动度评分增加更多(P<0.001)。研究组的 ODI 和 FABQ 评分降低更显著(P<0.017)。

结论

由于 DLS 运动在减轻疼痛、增加脊柱活动度和确保更快恢复工作方面的益处,因此可以向脊柱手术后的患者推荐该运动。

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