渐进式脊柱核心训练对改善胸腰椎骨折患者术后椎体功能的影响研究

Effect of progressive spinal core training on improving postoperative vertebral function in patients with thoracolumbar fractures

摘要:

目的 观察渐进式脊柱核心训练对改善胸腰椎骨折患者术后椎体功能恢复的影响。方法 本文为前瞻性研究，病例纳入南阳医学高等专科学校第一附属医院2021年1月至2022年6月收治的107例胸腰椎骨折患者，以随机数字表法将入组患者分为观察组（54例）和对照组（53例），两组均接受微创手术治疗，对照组术后予以常规康复训练，观察组术后实施渐进式脊柱核心训练，所有患者均开展8个月随访，比较两组椎体功能恢复情况及平衡功能、疼痛改善情况。结果 训练前，两组患者的Oswestry功能障碍指数（ODI），日本骨科协会治疗分数（JOA），Berg平衡量表（BBS），视觉模拟评分法（VAS）评分均差异无统计学意义（P>0.05）；经不同训练方式干预后，观察组1个月后的ODI评分为（30.44±5.12）分，4个月后的ODI评分为（24.11±5.28）分，8个月后的ODI评分为（18.44±5.41）分，均低于对照组［（33.49±5.36）分、（27.15±5.23）分、（22.19±5.39）分］（P<0.05）。观察组1个月后的JOA评分为（18.25±5.17）分，4个月后的JOA评分为（23.12±5.33）分，8个月后的JOA评分为（25.22±5.17）分，均高于对照组［（15.33±5.16）分、（20.44±5.25）分、（22.16±5.41）分］（P<0.05）。观察组1个月后的BBS评分为（40.33±5.17）分，4个月后的BBS评分为（46.25±10.27）分，8个月后的BBS评分为（51.66±10.39）分，均高于对照组［（37.25±5.41）分、（40.61±10.19）分、（46.62±10.33）分］（P<0.05）。观察组1个月后的VAS评分为（4.77±1.36）分，4个月后的VAS评分为（3.35±0.26）分，8个月后的VAS评分为（2.45±0.61）分，均低于对照组［（5.36±1.28）分、（4.23±1.22）分、（3.31±0.27）分］（P<0.05）。结论 渐进式脊柱核心训练能有效促进胸腰椎骨折患者术后椎体功能恢复，对改善患者平衡能力并缓解椎体疼痛均有积极意义。

关键词:胸腰椎骨折;渐进式脊柱核心训练;椎体功能;平衡能力;椎体疼痛

Abstract:

Objective To observe the effect of progressive spinal core training on improving postoperative vertebral function recovery in patients with thoracolumbar fractures.Methods This article is a prospective study, with cases included from January 2021 to June 2022. The study subjects were 107 patients with thoracolumbar fractures. The enrolled patients were randomly divided into an observation group (54 cases) and a control group (53 cases) using a random number table method. Both groups received minimally invasive surgical treatment, the control group received routine rehabilitation training after surgery, while the observation group received progressive spinal core training after surgery. All patients underwent an 8-month follow-up. The recovery of vertebral body function, balance function, and pain improvement between the two groups were compared.Results Before training, there was no statistically significant difference in ODI, JOA, BBS, and VAS scores between the two groups of patients (P>0.05). After different training methods, the ODI score of the observation group was 30.44±5.12 points after 1 month, 24.11±5.28 points after 4 months, and 18.44±5.41 points after 8 months. Compared with the control group (33.49±5.36 points, 27.15±5.23 points, and 22.19±5.39 points), the ODI score of the observation group was lower (P<0.05). The JOA score of the observation group after 1 month was 18.25±5.17 points, the JOA score after 4 months was 23.12±5.33 points, and the JOA score after 8 months was 25.22±5.17 points, which was higher than the control group (15.33±5.16 points, 20.44±5.25 points, 22.16±5.41 points) (P<0.05). The BBS score of the observation group after 1 month was 40.33±5.17 points, the BBS score after 4 months was 46.25±10.27 points, and the BBS score after 8 months was 51.66±10.39 points, which was higher than the control group (37.25±5.41 points, 40.61±10.19 points, 46.62±10.33 points) (P<0.05). The VAS score of the observation group after 1 month was 4.77±1.36 points, the VAS score after 4 months was 3.35±0.26 points, and the VAS score after 8 months was 2.45±0.61 points, which was lower than the control group (5.36±1.28 points, 4.23±1.22 points, and 3.31±0.27 points) (P<0.05).Conclusion Progressive spinal core training can effectively promote postoperative recovery of vertebral function in patients with thoracolumbar fractures, and has a positive significance in improving their balance ability and alleviating vertebral pain.

Key words:thoracic and lumbar spine fractures;progressive spinal core training;vertebral function;balance ability;vertebral pain