Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN, USA.
Physiother Theory Pract. 2021 Oct;37(10):1096-1108. doi: 10.1080/09593985.2019.1683921. Epub 2019 Oct 30.
: 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.
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。