Kernc Dejan, Strojnik Vojko, Vengust Rok
Faculty of Sport, University of Ljubljana, Gortanova 22, 1000, Ljubljana, Slovenia.
Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000, Ljubljana, Slovenia.
J Orthop Surg Res. 2018 Jun 19;13(1):151. doi: 10.1186/s13018-018-0853-7.
To analyze the safety and effects of early initiation of rehabilitation including objective measurement outcomes after lumbar spine fusion based on principles of strength training.
The study recruited 27 patients, aged 45 to 70 years, who had undergone lumbar spine fusion. The method of concealed random allocation without blocking was used to form two groups. The strength training group started rehabilitation 3 weeks after surgery. Patients exercised twice weekly over 9 weeks focusing on muscle activation of lumbopelvic stabilization muscles. The control group followed a standard postoperative protocol, where no exercises were performed at that stage of rehabilitation. Functional outcomes and plain radiographs were evaluated at 3 weeks and subsequently at 3 and 18 months after the surgery.
No hardware loosening of failure was observed in the training group. Both groups improved their walking speed after 3 months (p < 0.01), although improvement in the training group was significantly greater than in the control group (p < 0.01). Moreover, the training group significantly improved after the training period in all isometric trunk muscles measurements (p < 0.03), standing reach height (p < 0.02), and pre-activation pattern (p < 0.05). After 18 months, no training effects were observed.
The study showed that early initiation of a postoperative rehabilitation program based on principles of strength training is safe, 3 weeks after lumbar spine fusion, and enable earlier functional recovery than standard rehabilitation protocol.
The study is registered at the US National Institutes of Health ( ClinicalTrials.gov ) NCT03349580 . The date of registration: November 21, 2017 - Retrospectively registered.
基于力量训练原则分析腰椎融合术后早期开始康复治疗的安全性及效果，包括客观测量结果。
该研究招募了27名年龄在45至70岁之间接受过腰椎融合术的患者。采用非分组的隐蔽随机分配方法将患者分为两组。力量训练组在术后3周开始康复治疗。患者每周锻炼两次，共9周，重点是激活腰骨盆稳定肌。对照组遵循标准的术后方案，在康复的该阶段不进行锻炼。在术后3周以及随后的3个月和18个月时评估功能结果和X线平片。
训练组未观察到内固定松动或失败情况。两组在3个月后步行速度均有所提高（p < 0.01），尽管训练组的改善明显大于对照组（p < 0.01）。此外，训练组在训练期后所有等长躯干肌测量（p < 0.03）、站立伸展高度（p < 0.02）和预激活模式（p < 0.05）方面均有显著改善。18个月后，未观察到训练效果。
该研究表明，腰椎融合术后3周基于力量训练原则早期开始术后康复计划是安全的，并且比标准康复方案能实现更早的功能恢复。
该研究已在美国国立卫生研究院（ClinicalTrials.gov）注册，注册号为NCT03349580。注册日期：2017年11月21日——回顾性注册。
