Abstract:

Objective　To observe the application effect of core stabilization training in rehabilitation after surgery of elderly patients with thoracolumbar compression fractures. Methods　One hundred and eighteen patients with thoracolumbar compression fractures treated at Tongxu County Hospital of Traditional Chinese Medicine from January 2021 to October 2022 were selected for the randomized controlled trial, and were divided into a routine group and a rehabilitation group by the random number table method, with 59 cases in each group. There were 30 males and 29 females in the routine group; they were (65.22±5.36) years old. There were 32 males and 27 females in the rehabilitation group; they were (66.18±5.22) years old. The routine group did routine postoperative rehabilitation training; in addition, the rehabilitation group did core stabilization training. All the patients were followed up for 6 months. The injured vertebral structure, recovery of vertebral pain, improvement of vertebral function and body balance ability, and rehabilitation were compared between the two groups. t and χ² were applied. Results　After the intervention, the anterior edge height of the injured vertebrae in the rehabilitation group was higher than that in the routine group [(75.22±10.31)% vs. (70.23±10.46)%]; the posterior convex angle of the injured vertebrae and the Cobb angle in the rehabilitation group were lower than those in the routine group [(13.28±3.11)° vs. (15.62±3.25)° and (10.36±3.22)° vs. (12.41±3.25)°]; there were statistical differences (t=2.610, 3.996, and 3.442; all P<0.05). One, three, and six months of the follow up, the scores of Visual Analogue Scale and Oswestry Disability Index (ODI) in the rehabilitation group were lower than those in the routine group [(4.14±1.25) vs. (5.22±1.88), (3.06±0.77) vs. (4.24±1.06), and (2.45±0.31) vs. (3.07±0.45); (30.45±5.27) vs. (33.49±5.25), (25.66±5.14) vs. (28.42±5.31), and (21.44±5.27) vs. (24.33±5.46)], with statistical differences (t=3.675, 6.918, 8.715, 3.139, 2.869, and 2.925; all P<0.05). One, three, and six months of the follow up, the scores of Berg Balance Scale (BBS) in the rehabilitation group were higher than those in the routine group [(45.25±5.16) vs. (42.25±5.11), (50.27±5.35) vs. (47.62±5.32), (55.26±5.43) vs. (52.11±5.44)]; the hospitalization time and fracture healing time in the rehabilitation group were shorter than those in the routine group [(5.21±1.46)d vs. (7.35±2.47)d and (10.21±3.45) weeks vs. (12.27±3.28) weeks]; there were statistical differences (t=3.173, 2.698, 3.148, 5.729, and 3.324; all P<0.05). Conclusion　Core stabilization training for elderly patients with thoracolumbar compression fractures can effectively improve their vertebral structure and alleviate their vertebral pain, and is of great significance in promoting their recovery of vertebral function and balance ability and accelerating their rehabilitation process.

Key words:

Thoracolumbar compression fractures, Core stabilization training, Vertebral structure, Vertebral function, Rehabilitation process

摘要：

目的　观察核心稳定训练在老年胸腰椎压缩性骨折术后康复中的应用效果。方法　本研究为随机对照试验，选取2021年1月至2022年10月通许县中医院收治的118例老年胸腰椎压缩性骨折患者，采用随机数字表法分为常规组（59例）和康复组（59例）。常规组男30例、女29例，年龄（65.22±5.36）岁，实施常规术后康复训练；康复组男32例、女27例，年龄（66.18±5.22）岁，在常规组训练及治疗基础上联合实施核心稳定训练，所有患者均开展为期6个月短期随访。对比两组患者伤椎结构、椎体疼痛恢复情况、椎体功能及机体平衡能力改善、康复情况。采用t检验、χ²检验。结果　干预后，康复组伤椎前缘高度［（75.22±10.31）%］高于常规组［（70.23±10.46）%］，Cobb角［（13.28±3.11）°］、伤椎后凸角［（10.36±3.22）°］均低于常规组［（15.62±3.25）°、（12.41±3.25）°］，差异均有统计学意义（t=2.610、3.996、3.442，均P<0.05）。随访1个月、3个月、6个月，康复组视觉模拟评分法（VAS）评分［（4.14±1.25）分、（3.06±0.77）分、（2.45±0.31）分］、Oswestry功能障碍指数（ODI）评分［（30.45±5.27）分、（25.66±5.14）分、（21.44±5.27）分］均低于常规组［（5.22±1.88）分、（4.24±1.06）分、（3.07±0.45）分及（33.49±5.25）分、（28.42±5.31）分、（24.33±5.46）分］，差异均有统计学意义（t=3.675、6.918、8.715、3.139、2.869、2.925，均P<0.05）。随访1个月、3个月、6个月，康复组Berg平衡量表（BBS）评分［（45.25±5.16）分、（50.27±5.35）分、（55.26±5.43）分］均高于常规组［（42.25±5.11）分、（47.62±5.32）分、（52.11±5.44）分］，住院时间及骨折愈合时间［（5.21±1.46）d、（10.21±3.45）周］均短于常规组［（7.35±2.47）d、（12.27±3.28）周］，差异均有统计学意义（t=3.173、2.698、3.148、5.729、3.324，均P<0.05）。结论　核心稳定训练能有效改善老年胸腰椎压缩性骨折患者椎体结构，缓解椎体疼痛，对促进患者椎体功能及平衡能力恢复，加快患者康复进程有重要意义。

关键词:

胸腰椎压缩性骨折, 核心稳定训练, 椎体结构, 椎体功能, 康复进程