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经椎间孔腰椎椎间融合术后基于家庭康复的移动应用程序的临床效用及患者依从性

Clinical Utility and Patient Compliance With Mobile Applications for Home-Based Rehabilitation Following Transforaminal Lumbar Interbody Fusion.

作者信息

Cole Adam, Parry Matthew W, Tang Alex, Vazquez Frank, Chen Tan

机构信息

Geisinger Commonwealth School of Medicine, Geisinger College of Health Sciences, Scranton, PA, USA.

Department of Orthopaedic Surgery, Geisinger Musculoskeletal Institute, Wilkes Barre, PA, USA.

出版信息

Global Spine J. 2025 May;15(4):2032-2041. doi: 10.1177/21925682241282278. Epub 2024 Sep 6.

Abstract

Study DesignRetrospective chart review.ObjectivesTransforaminal lumbar interbody fusion (TLIF) via open or minimally invasive (MI) techniques is commonly performed. Mobile applications for home-based therapy programs have grown in popularity. The purpose of this study was to (1) compare patient-reported outcome measures (PROMs) between postoperative patients who were the most and least compliant in using the mobile-based rehabilitation programs, (2) compare PROMs between open vs MI-TLIF cohorts, and (3) quantify overall compliance rates of home-based rehabilitation programs.MethodsA retrospective chart review was performed. Patients were automatically enrolled in the rehabilitation program. Patient-Reported Outcomes Measurement Information System (PROMIS) and Oswestry Disability Index (ODI) scores were collected. Patients were separated into two study groups. Compliance rate was calculated as the difference between the number of active participants at the preoperative phase and final follow-up.Results220 patients were included. Average follow-up time was 23.2 months. No difference was found in the change in (∆) PROMIS scores ( = 0.261) or ∆ODI scores ( = 0.690) regardless of patient compliance. No difference was found in outcome scores between open vs MI-TLIF techniques stratified by download compliance (downloaded, DL+; did not download, DL-) and phone reminder compliance (set reminder, R+; did not set reminder, R-) postoperatively. Both cohorts demonstrated clinical improvement exceeding minimal clinically important difference at final follow-up. Overall patient compliance was 71% at final postoperative follow up.ConclusionDespite high long-term compliance and rising popularity, mobile applications for home-based postoperative rehabilitation programs have low clinical utility in patients undergoing TLIF.

摘要

研究设计

回顾性图表审查。

目的

经椎间孔腰椎椎间融合术(TLIF)可通过开放或微创(MI)技术进行。基于家庭治疗计划的移动应用程序越来越受欢迎。本研究的目的是:(1)比较在使用基于移动设备的康复计划中依从性最高和最低的术后患者之间的患者报告结局指标(PROMs);(2)比较开放与MI-TLIF队列之间的PROMs;(3)量化家庭康复计划的总体依从率。

方法

进行回顾性图表审查。患者自动纳入康复计划。收集患者报告结局测量信息系统(PROMIS)和奥斯维斯特残疾指数(ODI)评分。患者被分为两个研究组。依从率计算为术前阶段和最终随访时活跃参与者数量的差值。

结果

纳入220例患者。平均随访时间为23.2个月。无论患者依从性如何,PROMIS评分变化(∆)(P = 0.261)或∆ODI评分(P = 0.690)均无差异。术后按下载依从性(下载,DL+;未下载,DL-)和电话提醒依从性(设置提醒,R+;未设置提醒,R-)分层,开放与MI-TLIF技术之间的结局评分无差异。两个队列在最终随访时均显示临床改善超过最小临床重要差异。术后最终随访时患者总体依从率为71%。

结论

尽管长期依从性高且越来越受欢迎,但基于移动设备的家庭术后康复计划在接受TLIF的患者中临床效用较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2f0/12035362/7afa1a2e0d7b/10.1177_21925682241282278-fig1.jpg

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