工作强化训练对肌肉骨骼损伤工伤患者疗效观察

Therapeutic effect of work intensive training on workers with musculoskeletal injury

目的观察工作强化训练应用于肌肉骨胳损伤(MSI)工伤患者的疗效。方法采用方便抽样方法,选择MSI工伤患者为研究对象,采用随机数表法分为对照组(179例)和试验组(188例)。2组患者在接受常规综合康复治疗的基础上,对照组患者接受常规职业康复干预,试验组患者接受工作强化训练干预,干预训练周期均为4周。采用《创伤后应激障碍自评量表》《害怕-回避信念问卷》《一般自我效能感量表》评估患者康复情况。出院半年后,电话随访患者的复工状态。结果与同组干预前比较,对照组与试验组人群干预后的创伤后应激障碍、对体力活动的恐惧-回避信念(FABQ-P)和对工作的恐惧-回避信念(FABQ-W)得分均降低(P<0.01),自我效能得分均升高(P<0.01)。干预后,试验组人群的创伤后应激障碍、FABQ-P和FABQ-W得分均低于对照组(P<0.01),自我效能得分高于对照组(P<0.01)。试验组人群复工率高于对照组(80.9%vs 59.2%,P<0.01)。结论工作强化训练对MSI工伤患者在自我效能提升、体力活动和工作的主观疼痛影响、创伤后应激障碍水平等方面均有疗效,且可提升MSI工伤患者复工率。

Objective To observe the therapeutic effect of work intensive training on workers with musculoskeletal injury(MSI). Methods A convenience sampling method was used to select MSI patients as research subjects. Patients were randomly divided into control group(179 cases) and experimental group(188 cases). On the basis of the conventional comprehensive rehabilitation treatment, the control group received the routine occupational rehabilitation intervention, and the experimental group received the work intensive training intervention. The intervention period was 4 weeks in both groups. We used the Post-Traumatic Stress Disorder(PTSD) Self-Rating Scale, the Fear-Avoidance Beliefs Questionnaire(FABQ) and the General Self-efficacy Scale(GSES) to assess the recovery of MSI patients. The statuses of return to work of patients were followed up by telephone after six months of discharge from hospital. Results Compared with the same group before intervention, the scores of PTSD, FABQ-P and FABQ-W in the control group and the experimental group decreased, and the score of GSES increased(P<0.01). After the intervention, the scores of PTSD, FABQ-P and FABQ-W in the experimental group were lower than those in the control group(P<0.01), and the score of GSES was higher than those in the control group(P<0.01). The rate of returning to work in the experimental group was higher than that in the control group(80.9% vs 59.2%, P<0.01). Conclusion Work intensive training has curative effect on self-efficacy, physical activity, subjective pain, and post-traumatic stress disorder, and can improve the rate of resuming to work in patients with MSI.