关键词:

腰椎骨折, 康复治疗, 加快康复外科, 核心肌力训练

Abstract:

Objective　To observe the impact of core muscle strength training based on the ERAS concept on improving the postoperative rehabilitation outcomes in patients with lumbar vertebral fracture. Methods　This was a prospective cohort study. From March 2020 to February 2022, 100 patients with lumbar vertebral fracture in 988 Hospital of People's Liberation Army Joint Service Support Force were divided into a combined group [50 cases, 30 males and 20 females, aged 42-78 (60.26±5.41) years] and a conventional group [50 cases, 25 males and 25 females, aged 40-80 (61.35±5.25) years] by the random number table method. All patients received surgery. The conventional group received conventional rehabilitation treatment after surgery, and the combined group received core muscle strength training based on the ERAS concept to assist conventional rehabilitation treatment. Both groups were followed up for one year to compare the recovery of lumbar structure, lower back pain, balance ability, and long-term improvement of lumbar function before and after treatment. χ² test and t test were used. Results　After 3 months of treatment, the posterior convex angle and the Cobb angle of the injured vertebrae in the combined group were (13.25±3.11)° and (10.45±2.28)°, which were both lower than those in the conventional group [(15.17±3.02)° and (12.23±2.06)°], and the anterior edge height of the injured vertebrae was (75.36±10.24)%, which was higher than that in the conventional group [(69.77±10.21)%] (all P<0.05). The Visual Analogue Scale (VAS) score of the combined group was (5.15±1.24) points after 1 month and (3.28±0.25) points after 3 months, which were both lower than those of the conventional group [(6.65±2.13) points and (4.49±1.25) points]; the Berg Balance Scale (BBS) score of the combined group was (42.14±10.36) points after 1 month and (54.11±10.37) points after 3 months, which were both higher than those of the conventional group [(36.62±10.33) points and (48.24±10.28) points] (all P<0.05). Under different treatment regiments, the Oswestry Disability Index (ODI) scores of the combined group were (35.25±5.41) points and (23.49±5.11) points at the 3rd month and the 9th month of follow up, which were both lower than those of the conventional group [(38.77±5.24) points and (27.12±5.44) points]; the Japanese Orthopaedic Association (JOA) scores of the combined group were (18.33±5.15) points and (26.15±5.14) points at the 3rd month and the 9th month of follow up, which were both higher than those of the conventional group [(15.44±5.33) points and (22.41±5.15) points] (all P<0.05). Conclusion　The core muscle strength training based on the ERAS concept can effectively improve the postoperative vertebral structure in patients with lumbar vertebral fracture, and has positive significance in alleviating the postoperative lumbar pain, enhancing the body balance ability, and promoting the long-term recovery of vertebral function.

Key words:

Lumbar vertebral fracture, Rehabilitation treatment, ERAS, Core muscle strength training