摘要
目的分析腰椎间盘突出症(LDH)患者不同维度的胸腰椎活动度(ROM)对非手术治疗后功能恢复的影响。方法回顾性分析2020年12月至2022年3月该院康复科1211例住院腰痛患者资料,选取符合纳入排除标准的患者465例作为研究对象。采用日本骨科协会(JOA)腰痛评分评估患者功能障碍程度,根据JOA腰痛评分改善率将患者分为疗效不佳组(改善率<60%,n=270)和显效组(改善率≥60%,n=195)。收集患者年龄、性别、体重指数(BMI)、住院时间、病程和相关并发症等一般资料,以及出入院时胸腰椎ROM及其改善程度、JOA腰痛评分等观察指标。采用单因素和多因素二项logistic回归分析LDH患者功能恢复的影响因素。结果两组患者年龄、病程、入院时后伸、右侧旋转ROM,以及出院时6个方向ROM改善程度均有明显差异(P<0.05)。多因素二项logistic回归分析结果显示:LDH患者入院时前屈、后伸ROM[OR=1.08,95%CI(1.05~1.11),P<0.01;OR=1.06,95%CI(1.01~1.12),P=0.01]和出院时前屈、左侧侧屈ROM改善程度[OR=1.08,95%CI(1.05~1.17),P=0.02;OR=1.01,95%CI(0.95~1.07),P<0.01]与患者的功能恢复呈正相关,患者年龄与出院时右侧旋转ROM改善程度[OR=0.98,95%CI(0.96~1.00),P<0.01;OR=0.98,95%CI(0.88~1.09),P<0.01]与患者功能恢复呈负相关。结论LDH患者胸腰椎矢状面上的活动范围可预测其功能恢复情况,活动性越好,功能恢复越好,并应重点改善前屈和左侧侧屈ROM,有助于改善患者整体的功能恢复状况。
Objective To analyze the influence of different dimensions of thoracolumbar range of motion(ROM)on functional recovery after non-surgical treatment in patients with lumbar disc herniation(LDH).Methods A retrospective analysis was conducted on the data of 1211 hospitalized patients with low back pain in the rehabilitation department of this hospital from December 2020 to March 2022.A total of 465 patients who met the inclusion and exclusion criteria were selected as the study subjects.The Japanese Orthopedic Association(JOA)low back pain score was used to evaluate the degree of functional impairment in patients.Based on the improvement rate of the JOA low back pain score,the patients were divided into the ineffective group(improvement rate<60%,n=270)and the significantly effective group(improvement rate≥60%,n=195).The general information such as patient age,gender,body mass index(BMI),length of hospital stay,course of disease,and related complications,as well as observation indicators such as thoracolumbar ROM at admission and exit and its degree of improvement,and JOA low back pain score were collected.The influencing factors of functional recovery in LDH patients were analyzed by using the univariate and multivariate binomial logistic regression.Results There were significant differences in age,course of disease,extension,right rotation ROM at admission,and ROM improvement in six directions at discharge between patients in the two groups(P<0.05).The results of multivariate binomial logistic regression analysis showed that the ROM of forward flexion and extension in LDH patients at admission[OR=1.08,95%CI(1.05-1.11),P<0.01;OR=1.06,95%CI(1.01-1.12),P=0.01]and the degree of improvement in ROM of forward flexion and left lateral flexion at discharge[OR=1.08,95%CI(1.05-1.17),P=0.02;OR=1.01,95%CI(0.95-1.07),P<0.01]were positively correlated with patients’functional recovery.The age of the patients and the degree of improvement in right rotation ROM at discharge[OR=0.98,95%CI(0.96-1.00),P<0.01;OR=0.98,95%CI(0.88-1.
作者
李万庭
吕志刚
侯为林
LI Wanting;LYU Zhigang;HOU Weilin(Department of Rehabilitation,Changzhou Affiliated Hospital of Nanjing University of Chinese Medicine,Changzhou,Jiangsu 210023,China)
出处
《重庆医学》
CAS
2023年第10期1530-1534,共5页
Chongqing medicine
关键词
腰椎间盘突出症
活动范围
功能恢复
非手术治疗
lumbar disc herniation
range of motion
recovery of function
non-surgical treatment
