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颈椎前路椎间盘切除融合术后早期电话支持家庭运动方案的安全性和可行性:病例系列研究。

Safety and feasibility of an early telephone-supported home exercise program after anterior cervical discectomy and fusion: a case series.

机构信息

Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.

Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN, USA.

出版信息

Physiother Theory Pract. 2021 Oct;37(10):1096-1108. doi: 10.1080/09593985.2019.1683921. Epub 2019 Oct 30.

Abstract

: To describe the safety, feasibility, and preliminary outcomes of an early telephone-supported home exercise program (HEP) performed within the first 6 weeks after anterior cervical discectomy and fusion (ACDF) surgery.: Eight patients (mean ± SD age = 53.4 ± 14.9 years, 5 females) were enrolled in this case series. Immediately after surgery, patients began a 6-week HEP including daily walking, deep breathing, distraction techniques, and cervical and upper body exercises. The HEP was supported by weekly telephone calls by a physical therapist. Safety for performing early exercise was examined with radiographic imaging at 6 months. Adverse events were assessed through weekly calls with a physical therapist. HEP adherence and acceptability data were obtained by patient self-report. Clinical measures were assessed preoperatively, at 6 weeks and at 6 months, and included the Neck Disability Index, Numeric Rating Scale for pain, Tampa Scale of Kinesiophobia, Pain Catastrophizing Scale, Pain Self-Efficacy Questionnaire, and accelerometry for physical activity.: Early radiographic imaging showed no signs of nonunion at 6 months. There were no reports of serious adverse events. At 6 months, all patients reported clinically significant changes in pain catastrophizing. Seven (88%) patients had clinically significant changes in disability and arm pain, six (75%) patients for neck pain and pain self-efficacy, and five (53%) patients for fear of movement. Only three (43%) of seven patients showed increased physical activity at 6 months.: Based on this small case series, an early telephone-supported HEP appears safe for patients, feasible to implement, and promising for clinical benefits.

摘要

描述在颈椎前路椎间盘切除融合术(ACDF)后 6 周内早期电话支持家庭运动计划(HEP)的安全性、可行性和初步结果。

本病例系列纳入了 8 名患者(平均年龄±标准差为 53.4±14.9 岁,女性 5 名)。术后即刻,患者开始进行为期 6 周的 HEP,包括日常步行、深呼吸、分散注意力技术以及颈部和上半身锻炼。HEP 由物理治疗师每周通过电话提供支持。通过术后 6 个月的影像学检查评估早期运动的安全性。通过每周与物理治疗师的电话评估不良事件。HEP 依从性和可接受性数据通过患者自我报告获得。术前、术后 6 周和 6 个月评估临床指标,包括颈椎残障指数、疼痛数字评分量表、运动恐惧量表、疼痛灾难化量表、疼痛自我效能问卷和加速度计用于评估身体活动。

术后 6 个月的早期影像学检查未见非融合迹象。无严重不良事件报告。术后 6 个月,所有患者报告疼痛灾难化明显改善。7 名(88%)患者的残疾和手臂疼痛、6 名(75%)患者的颈部疼痛和疼痛自我效能、5 名(53%)患者的运动恐惧有显著改善。仅 7 名患者中的 3 名(43%)在术后 6 个月时显示身体活动增加。

基于这项小病例系列研究,早期电话支持的 HEP 对患者是安全的、可行的,并有望带来临床获益。

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