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[接受减压稳定干预的脊柱疾病患者术后早期姿势稳定训练]

[Early postoperative stabilometric training in patients with spinal diseases who underwent decompressive-stabilizing interventions].

作者信息

Strelnikova A V, Samokhin A G, Krut'ko A V, Peleganchuk A V, Kiselev A S, Drobyshev V A, Mikhailov V P

机构信息

Ya.L. Tsiviyan Novosibirsk Research Institute of Traumatology and Orthopedics, Ministry of Health of Russia, Novosibirsk, Russia; Siberian State Medical University, Ministry of Health of Russia, Tomsk, Russia.

Ya.L. Tsiviyan Novosibirsk Research Institute of Traumatology and Orthopedics, Ministry of Health of Russia, Novosibirsk, Russia.

出版信息

Vopr Kurortol Fizioter Lech Fiz Kult. 2019;96(3):31-40. doi: 10.17116/kurort20199603131.

Abstract

AIM

To study the impact of rehabilitation measures on the dynamics of pain syndrome and on the state of postural muscle balance in the early postoperative period in patients with degenerative-dystrophic diseases of the lumbar spine who have undergone decompressive-stabilizing interventions.

MATERIAL AND METHODS

This paper comparatively analyzed the level of pain syndrome in the lumbar spine and lower extremities, the stabilometric indicators characterizing the amplitude of center-of-pressure oscillations in patients who had undergone decompressive-stabilizing operations at 7±2 days after surgical treatment for degenerative-dystrophic diseases of the lumbar spine. Two groups of 60 people in each were formed: rehabilitation measures were implemented, starting on day 2 of an early postoperative period (the duration of the latter was 7±2 days after surgery); the basic complex was supplemented with stabilometric training in Group 1 (a study group); only the basic complex was used in Group 2 (a comparison group).

RESULTS

In the study group, the frequency of rehabilitation outcomes with an achieved excellent result depending on the level of pain syndrome in the lower extremities and spine on a visual analogue scale was 62.5 and 88.9%, respectively; which significantly statistically exceeds the proportion of patients with the same outcome in the comparison group (37.5 and 11.1%; p<0.01 in both cases). There was a statistically significant more pronounced decrease in the level of pain syndrome in the lumbar spine (p=0.0001) and lower limbs (p=0.003) in the patients of the study group in the early postoperative period. Intergroup comparison revealed a statistically significant decrease in all the indicators monitored in the study, which characterize the amplitude of the center-of-pressure oscillations. Moreover, the value of the oscillation area parameter between the patient groups differed by 1.76 and 1.83 times during Romberg's test with the eyes open or closed, respectively (p=0.0001).

CONCLUSION

The findings suggest that the comprehensive treatment supplemented with stabilometric training in the early postoperative period improves the state of postural muscle balance. There was a statistically significant predominance of compliance with normative values in patients of the study group during Romberg's test with the eyes open or closed (p=0.007 and p=0.00002, respectively), which contributes to a more marked decrease in the level of pain syndrome in the lumbar spine (p=0.001) and lower extremities (p=0.003).

摘要

目的

研究康复措施对腰椎退行性营养不良疾病患者减压稳定干预术后早期疼痛综合征动态变化及姿势肌肉平衡状态的影响。

材料与方法

本文比较分析了腰椎退行性营养不良疾病患者接受减压稳定手术后7±2天腰椎和下肢疼痛综合征水平,以及表征压力中心振荡幅度的稳定测量指标。每组60人,分为两组:术后早期第2天开始实施康复措施(术后持续7±2天);第1组(研究组)在基本综合治疗基础上增加稳定测量训练;第2组(对照组)仅采用基本综合治疗。

结果

研究组中,根据视觉模拟量表,下肢和脊柱疼痛综合征水平达到优异康复效果的频率分别为62.5%和88.9%;这在统计学上显著超过对照组相同结果患者的比例(分别为37.5%和11.1%;两种情况p<0.01)。研究组患者术后早期腰椎(p = 0.0001)和下肢(p = 0.003)疼痛综合征水平在统计学上有更显著的下降。组间比较显示,研究中监测的所有表征压力中心振荡幅度的指标在统计学上有显著下降。此外,在睁眼或闭眼的罗姆伯格试验期间,患者组之间振荡面积参数值分别相差1.76倍和1.83倍(p = 0.0001)。

结论

研究结果表明,术后早期补充稳定测量训练的综合治疗可改善姿势肌肉平衡状态。在睁眼或闭眼的罗姆伯格试验中,研究组患者符合规范值的比例在统计学上占显著优势(分别为p = 0.007和p = 0.00002),这有助于腰椎(p = 0.001)和下肢(p = 0.003)疼痛综合征水平更显著地下降。

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