Chen Chen-Yin, Chang Chia-Wei, Lee Shih-Tseng, Chen Yung-Cheng, Tang Simon Fuk-Tan, Cheng Chih-Hsiu, Lin Yang-Hua
Division of Physical Therapy, Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taiwan.
Department of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taiwan; Healthy Aging Research Center, Chang Gung University, Taiwan.
Clin Neurol Neurosurg. 2015 Feb;129 Suppl 1:S41-6. doi: 10.1016/S0303-8467(15)30011-1.
Rehabilitation has been reported to improve pain and disability for patients after lumbar surgery. However, studies to investigate the rehabilitation intervention for lumbar decompression surgery during hospitalization are scarce. The aim of this study was to examine outcomes of perioperative rehabilitation intervention for patients who underwent lumbar decompression surgery (LDS).
Patients aged 18-65 years old who received their first LDS were randomized into the perioperative rehabilitation group (PG) or control group (CG). The PG received rehabilitation intervention during hospitalization for lumbar decompression surgery. Pain, functional capacity, Roland-Morris Disability Questionnaire (RMDQ), and Short-Form Health Survey (SF-12) were assessed on admission, at discharge, and at follow-ups one month, three months, and six months after surgery. Two-way repeated measures ANOVAs were used for statistical analysis.
A total of 60 patients scheduled for decompression surgery for lumbar stenosis were enrolled into the study. After surgery, the PG showed significant pain relief and improvement of disability as well as quality of life, but there were no significant functional improvements compared with the CG.
The findings of this study indicate that the rehabilitation intervention during hospitalization improves pain intensity as well as disability and quality of life, yet has limited effects on the functional performance over time up to six months post-surgery in patients who received LDS. The study suggest that rehabilitation interventions during hospitalization must include regular support for patient adherence to the intervention program and focus on task-oriented programs for lower extremities such as closed-chain exercises in functional postures.
据报道,康复治疗可改善腰椎手术后患者的疼痛和功能障碍。然而,关于住院期间腰椎减压手术康复干预的研究却很少。本研究的目的是探讨接受腰椎减压手术(LDS)患者围手术期康复干预的效果。
将年龄在18 - 65岁之间接受首次LDS的患者随机分为围手术期康复组(PG)或对照组(CG)。PG在住院期间接受腰椎减压手术的康复干预。在入院时、出院时以及术后1个月、3个月和6个月的随访中评估疼痛、功能能力、罗兰·莫里斯残疾问卷(RMDQ)和简短健康调查问卷(SF - 12)。采用双向重复测量方差分析进行统计分析。
共有60例计划进行腰椎管狭窄减压手术的患者纳入本研究。术后,PG组在疼痛缓解、功能障碍改善以及生活质量方面均有显著改善,但与CG组相比,功能改善不显著。
本研究结果表明,住院期间的康复干预可改善疼痛强度、功能障碍和生活质量,但对接受LDS手术的患者术后长达6个月的功能表现影响有限。该研究表明,住院期间的康复干预必须包括定期支持患者坚持干预计划,并侧重于针对下肢的任务导向性计划,如功能性姿势下的闭链运动。