Missmann Martin, Grote Vincent, Riedl David, Grenier Jean-Pascal, Fischer Michael J
Austrian Workers' Compensation Board AUVA, Ingenieur-Etzel-Str. 17, 6020 Innsbruck, Austria.
Ludwig Boltzmann Institute for Rehabilitation Research, Kurbadstraße 14, 1100 Vienna, Austria.
J Clin Med. 2023 Jan 28;12(3):1004. doi: 10.3390/jcm12031004.
The present study aimed to compare changes during inpatient rehabilitation between conservatively and surgically treated patients. A total of = 162 patients with cervical spine complaints were included in the study ( = 107 conservatively treated, = 55 after surgery). Patients completed disease-specific (NDI) and generic (NPRS, EQ-5D-5L, HAQ) patient reported outcome measures (PROMs) before and after rehabilitation. In addition, the range of motion (ROM) in the transversal plane of the cervical spine was measured. Changes and correlations between PROMs and ROM values during rehabilitation were assessed. The influence of moderating factors on NDI outcomes was examined. Significant improvements with large effect sizes were found in PROMs and ROM (all < 0.001). The conservatively treated patients showed significantly greater NDI improvements than operated patients ( = 0.050), but a greater proportion of poor performance in ROM ( = 0.035). Baseline NDI (β = 0.66), HAQ (β = 0.14), and ROM scores (β = -0.17) explained 63.7% of the variance in NDI after rehabilitation. Both patient groups showed different outcomes. The findings of this study indicate that the unique needs of patients may require different therapeutic interventions and highlight the importance of using multidimensional outcome measures when implementing a multimodal rehabilitation approach.
本研究旨在比较保守治疗和手术治疗患者在住院康复期间的变化。共有162例颈椎疾病患者纳入研究（保守治疗107例，手术治疗55例）。患者在康复前后完成了疾病特异性（NDI）和通用型（NPRS、EQ-5D-5L、HAQ）患者报告结局指标（PROMs）。此外，还测量了颈椎横断面的活动范围（ROM）。评估了康复期间PROMs与ROM值之间的变化及相关性。研究了调节因素对NDI结局的影响。PROMs和ROM均有显著改善，效应量较大（均P<0.001）。保守治疗患者的NDI改善程度显著高于手术患者（P = 0.050），但ROM表现较差的比例更高（P = 0.035）。基线NDI（β = 0.66）、HAQ（β = 0.14）和ROM评分（β = -0.17）解释了康复后NDI方差的63.7%。两组患者表现出不同的结局。本研究结果表明，患者的独特需求可能需要不同的治疗干预措施，并强调了在实施多模式康复方法时使用多维结局指标的重要性。
