整体功能性体育锻炼对腰椎间盘突出症术后患者腰椎生物力学的影响  

Effect of overall functional physical exercise on lumbar biomechanics in patients with lumbar disc herniation after surgery

作　　者：杨煜 李英豪[1] 多壮志[2] 周定容 Yang Yu;Li Yinghao;Duo Zhuangzhi;Zhou Dingrong(Zhengzhou Shengda College of Economics and Trade,Zhengzhou 451191,Henan Province,China;Department of Physical Education,Zhengzhou University,Zhengzhou 450001,Henan Province,China;Department of Orthopedics of Henan Provincial People’s Hospital,Zhengzhou 454002,Henan Province,China)

机构地区：[1]郑州升达经贸管理学院,河南省郑州市451191 [2]郑州大学体育系,河南省郑州市450001 [3]河南省人民医院骨科,河南省郑州市454002

出　　处：《中国组织工程研究》2025年第33期7096-7101,共6页Chinese Journal of Tissue Engineering Research

基　　金：河南省教育课程改革研究项目(2024-JSJYYB-133),项目负责人:李英豪。

摘　　要：背景:经皮椎间孔镜椎间盘切除术患者预后较差,预后较差的原因与缺少功能锻炼有关,常规的康复方法疗效有限,主要原因是康复方法较单一且缺少针对性,因此需要改进整体功能性体育锻炼方法。目的:探讨整体功能性体育锻炼对行经皮椎间孔镜椎间盘切除的腰椎间盘突出症患者术后腰椎生物力学的影响。方法:选择2021年4月至2022年9月在河南省人民医院行经皮椎间孔镜椎间盘切除术的腰椎间盘突出症患者120例作为研究对象,根据随机数法随机分为传统康复组和整体功能性体育锻炼组,两组患者分别进行8周的传统康复和整体功能性体育锻炼。在干预前和干预8周后,使用IsoMed2000等速肌力测试系统进行等速肌力测试;应用Oswestry功能障碍指数评估腰椎功能;以目测类比评分法评价疼痛程度;以焦虑自评量表和抑郁自评量表评估焦虑和抑郁症状。在锻炼干预8周后,采用改良Macnab疗效评定标准评定疗效。结果与结论:①干预8周后,与传统康复组比较,整体功能性体育锻炼组患者的腰背肌群屈肌和伸肌峰力矩、平均功率均升高,屈伸峰力矩比降低,Oswestry功能障碍指数、目测类比评分、焦虑自评量表和抑郁自评量表评分均降低,改良Macnab疗效优良率升高(P<0.001);②提示与传统康复方案相比,腰椎间盘突出症患者经皮椎间孔镜椎间盘切除术后进行整体功能性体育锻炼可有效改善腰椎生物力学和功能、缓解疼痛、减少术后不良情绪、改善预后,具有较高的临床价值。BACKGROUND:The prognosis of patients undergoing percutaneous transforaminal endoscopic discectomy is poor,which is related to the lack of functional physical exercise.Conventional rehabilitation methods have limited efficacy,mainly because the rehabilitation methods are relatively single and lack specificity.Therefore,it is necessary to improve the overall functional physical exercise method.OBJECTIVE:To explore the effect of overall functional physical exercise on lumbar biomechanics in patients with lumbar disc herniation who underwent percutaneous transforaminal endoscopic discectomy.METHODS:120 patients who met the percutaneous intervertebral foramen discectomy indication and underwent percutaneous intervertebral foramen discectomy operation in Henan Provincial People’s Hospital from April 2021 to September 2022 were selected as study subjects.They were randomly divided into traditional rehabilitation group and overall functional physical exercise group.Patients in the two groups received 8 weeks of traditional rehabilitation and overall functional physical exercise respectively.Before the exercise intervention and after 8 weeks of intervention,the IsoMed2000 isokinetic muscle strength testing system was used to conduct isokinetic muscle strength testing.The Oswestry Disability Index was used to evaluate lumbar spine function.The visual analog scale was used to evaluate the pain level.The anxiety self-rating scale and depression self-report scale were used to assess symptoms of anxiety and depression.After 8 weeks of exercise intervention,the modified Macnab efficacy evaluation standard was used to evaluate the efficacy.RESULTS AND CONCLUSION:(1)Compared with the traditional rehabilitation group,the peak torque and average power of flexion and extensor in the whole functional physical exercise group increased,the peak torque ratio of flexion and extension decreased,Oswestry disability index score,visual analog scale score,self-rating anxiety scale score and self-rating depression scale score decreased,and t

关 键 词：腰椎间盘突出症 经皮椎间孔镜椎间盘切除 整体功能性体育锻炼 传统康复 腰椎生物力学 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R681.5