个性化康复指导对颈腰椎病患者躯体功能康复的影响

发布时间：2018-06-19 02:32

本文选题：个性化康复 + 颈椎病　；参考：《上海交通大学》2015年硕士论文

【摘要】：目的:在颈椎病及腰椎间盘突出症患者间实施推广个性化的康复指导方案,观察该治疗方法对颈椎病及腰椎间盘突出症患者躯体功能康复疗效的影响。方法:60例颈椎病及腰椎间盘突出症患者,年龄30-50岁,随机分为两组:一组给予常规康复治疗及宣教指导,为对照组;另一组给予常规康复治疗基础上,予个性化评估及个性化康复指导,以口头、书面、照片、视频等形式,为个性化组。分别在治疗前,治疗后每周一次,治疗结束时由第三方盲法,应用疼痛视觉模拟评分(Visual Analogue Scale,VAS)、日本骨科学会(Japanese Orthopedic Association,JOA)下背痛或颈椎评分、SF-36简明健康问卷(the MOS 36-item Short From Health Survey)进行评估。结果:观察者取自2014年9月至2015年1月上海市第一人民医院康复科门诊及康复中心就诊患者,其中男27例,女33例,平均年龄39.37(±6.40)岁,所有患者均进入结果分析,无脱落。采用单因素方差分析进行统计,治疗前两组患者的VAS、JOA、SF-36得分水平无显著差异(P0.05);在治疗1周后,对照组和个性化组患者的VAS得分分别5.20±1.10和4.43±1.20,存在显著统计学差异(F=6.714,P0.05);两组JOA得分分别为16.00±2.32和17.47±2.45,同样存在显著统计学差异(F=5.680,P0.05)。2周的治疗结束时,对照组和个性化组的VAS得分分别为4.13±1.28和2.73±1.26,差异非常显著(F=18.270,P0.01);两组JOA得分为17.20±2.40和19.40±3.36,存在非常显著统计学差异(F=8.524,P0.01);两组SF-36评分分别为114.37±14.30,123.03±13.10,组间比较有显著统计学差异(F=5.990,P0.05)。对多个时间点的组间、组内比较使用重复测量方差分析,结果显示随时间变化两组有VAS降低、JOA和SF提高的趋势,并且时间因素的作用随着分组的不同而不同,个性化组的整体疗效趋势好于对照组。结论:相比单采用常规康复治疗及指导,同时对颈椎病及腰椎间盘突出患者进行个性化的康复指导可取得更优效果。
[Abstract]:Objective: to investigate the effect of individualized rehabilitation guidance program on the physical function of patients with cervical spondylosis and lumbar disc herniation. Methods Sixty patients with cervical spondylosis and lumbar disc herniation, aged 30-50 years, were randomly divided into two groups: one group was treated with routine rehabilitation therapy and the other group was treated with routine rehabilitation therapy. Personalized evaluation and individualized rehabilitation instruction, in oral, written, photo, video and other forms, for personalized group. Before and once a week after treatment, the patients were evaluated by the third party blind method with visual Analogue scale and Japanese Orthopedic Association / JOA-Japanese Orthopedic Association / Japanese Orthopedic Association (JOAA). Results: observers were collected from outpatients and rehabilitation centers of the first people's Hospital of Shanghai from September 2014 to January 2015. There were 27 males and 33 females with an average age of 39.37 (卤6.40) years. Using univariate analysis of variance, there was no significant difference in VAS-JOASF-36 score between the two groups before treatment, and after one week of treatment, there was no significant difference in the scores of VAS-JOASF-36. The VAS scores of the control group and the individualized group were 5.20 卤1.10 and 4.43 卤1.20, respectively. There was significant statistical difference between the two groups (P < 0.05), the JOA scores of the two groups were 16.00 卤2.32 and 17.47 卤2.45, respectively. The scores of VAS in control group and individuation group were 4.13 卤1.28 and 2.73 卤1.26, respectively, the difference was very significant (P < 0.05), the scores of JOA in two groups were 17.20 卤2.40 and 19.40 卤3.36, respectively. The scores of SF-36 in two groups were 114.37 卤14.30123.03 卤13.10, respectively. The results showed that VAS decreased JOA and SF increased in two groups over time, and the effect of time factors varied with different groups. The overall therapeutic effect of the individualized group was better than that of the control group. Conclusion: compared with routine rehabilitation therapy and guidance, individualized rehabilitation guidance for patients with cervical spondylosis and lumbar disc herniation can achieve better results.
【学位授予单位】：上海交通大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R681.55

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