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一名术后肱骨干骨折患者的运动恐惧:一名16岁女孩运动恐惧对康复影响的病例报告

Kinesiophobia in a Patient With Postoperative Midshaft Fracture: A Case Report of Its Impact on Rehabilitation in a 16-Year-Old Girl.

作者信息

Wane Madhuri, Naqvi Waqar M, Vaidya Laukik, Kumar Kiran

机构信息

Occupational Therapy, Datta Meghe Institute of Medical Sciences, Wardha, IND.

Community Physiotherapy, Datta Meghe Institute of Medical Sciences, Wardha, IND.

出版信息

Cureus. 2020 Nov 5;12(11):e11333. doi: 10.7759/cureus.11333.

Abstract

Kinesiophobia is an irrational and debilitating fear of physical movement and activity resulting from a feeling of vulnerability to painful injury or re-injury. According to the concept of avoidance of fear, pain is interpreted as threatening, which can trigger pain-related fears and anxiety leading to avoidance behavior. Avoidance action involves a process/period characterized by a person stepping back from undertaking daily tasks like exercise, socializing, and work, which increases the intensity of the painful experience. In hospital settings, kinesiophobia needs to be resolved to ensure a positive result in rehabilitation interventions. The femur is the lower extremity's primary weight-bearing bone. Early fracture fixation in the shaft of the femur allows for early mobilization, thereby reducing the risk of hip and knee stiffness as well as quadriceps and hamstring wasting. In this report, we present the case of a 16-year-old girl with an alleged history of fall who was admitted to Acharya Vinobha Bhave Rural Hospital (AVBRH), Datta Meghe Institute of Medical Sciences (DMIMS) Deemed To Be University (DU), Wardha, India, with primary complaints of pain and swelling over the left thigh. She was diagnosed with a left midshaft femur fracture. An open reduction internal fixation (ORIF) femur interlock nailing was performed to stabilize the fracture, and she was referred to physiotherapy after surgery for further management. The comprehensive rehabilitation program was helpful in alleviating the severe kinesiophobia in the patient, and she was able to resume her activities of daily living (ADLs) independently.

摘要

运动恐惧是一种对身体运动和活动的非理性且使人衰弱的恐惧,源于对疼痛性损伤或再次受伤的易感性。根据恐惧回避概念,疼痛被解读为具有威胁性,这会引发与疼痛相关的恐惧和焦虑,进而导致回避行为。回避行为涉及一个过程/阶段,其特征是一个人从进行诸如锻炼、社交和工作等日常任务中退缩,这会增加疼痛体验的强度。在医院环境中,需要解决运动恐惧以确保康复干预取得积极效果。股骨是下肢的主要承重骨。股骨骨干的早期骨折固定可实现早期活动,从而降低髋部和膝部僵硬以及股四头肌和腘绳肌萎缩的风险。在本报告中,我们介绍了一名16岁女孩的病例,她据称有跌倒史,因左大腿疼痛和肿胀的主要症状入住印度沃达哈市达塔·梅格医学科学研究所(被视为大学)阿查里亚·维诺巴·巴韦农村医院(AVBRH)。她被诊断为左股骨中段骨折。进行了切开复位内固定(ORIF)股骨交锁髓内钉固定术以稳定骨折,术后她被转介至物理治疗科进行进一步治疗。综合康复计划有助于减轻患者严重的运动恐惧,她能够独立恢复日常生活活动(ADL)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c5b/7719470/383bbfe9d145/cureus-0012-00000011333-i01.jpg

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