认知行为疗法结合普拉提运动在腰椎间盘突出症术后病人护理中的应用

Application of cognitive behavior therapy combined with Pilates exercise in postoperative patients with lumbar intervertebral disc herniation

目的:探讨认知行为疗法结合普拉提运动对腰椎间盘突出症(LDH)术后病人恐动症及康复依从性的影响。方法:选取2019年6月—2020年7月湖州市某三级医院择期行LDH手术病人68例。采用随机数字表法分为两组,各34例。对照组给予常规护理、认知行为疗法;观察组在对照组基础上增加普拉提运动,干预时间从术后第1周到第6周,比较两组病人术后1周、4周、6周恐动症量表(TSK)、Oswestry残疾指数(ODI)及骨科病人功能锻炼依从性量表评分。结果:观察组术后1周、4周、6周TSK得分为(34.56±2.34)分、(27.35±3.47)分、(22.00±2.65)分;对照组术后1周、4周、6周TSK得分为(37.47±2.34)分、(30.97±3.47)分、(25.18±3.07)分,两组比较差异有统计学意义(P<0.001)。观察组术后1周、4周、6周ODI得分为(33.21±3.42)分、(27.97±3.71)分、(23.29±3.15)分;对照组术后1周、4周、6周ODI得分为(37.88±3.02)分、(33.82±3.26)分、(30.18±3.24)分,两组比较差异有统计学意义(P<0.001)。观察组术后1周、4周、6周骨科病人功能锻炼依从性量表得分为(39.00±2.23)分、(46.56±2.63)分、(57.21±2.91)分,对照组术后1周、4周、6周骨科病人功能锻炼依从性量表得分为(33.94±2.30)分、(41.12±3.04)分、(49.06±4.55)分,两组比较差异有统计学意义(P<0.001)。结论:LDH术后病人实施认知行为疗法结合普拉提运动有助于降低运动恐惧程度,促进腰椎功能的早期恢复,提高术后病人康复锻炼的依从性。

Objective:To investigate the impact of cognitive-behavioral therapy combined with Pilates exercise on kinesiophobia and rehabilitation compliance of patients with lumbar intervertebral disc herniation(LDH)surgery.Methods:A total of 68 patients undergoing elective LDH surgery in a third hospital in Huzhou from June 2019 to July 2020 were randomly divided into two groups,with 34 cases in each.The patients in control group received routine care and cognitive behavioral therapy;the patients in observation group added Pilates exercise based on the control group.The intervention period was from the 1st week to the 6th week after the operation.compare the scores Terrorism Scale(TSK),Oswestry Disability Index(ODI),and Functional Exercise Compliance Scale for Orthopedic Patients at 1 week,4 weeks,and 6 weeks after the operation.Results:At first week,fourth week,and sixth week after surgery,the TSK scores of patients in the observation group were(34.56±2.34),(27.35±3.47),and(22.00±2.65),respectively;the TSK scores in the control group were(37.47±2.34),(30.97±3.47),and(25.18±3.07),respectively;the difference between the two groups was statistically significant(P<0.001).T h e O D I s c o re s in t h e ob se r v a tio n group were(33.21±3.42),(27.97±3.71),and(23.29±3.15),respectively;the scores in the control group were(37.88±3.02),(33.82±3.26),and(30.18±3.24),respectively;the difference between the two groups was statistically significant(P<0.001).The observation group's scores of Functional Exercise Compliance Scale for Orthopedic Patients were(39.00±2.23),(46.56±2.63),and(57.21±2.91),respectively;the scores in the control group were(33.94±2.30),(41.12±3.04),and(49.06±4.55),respectively;the difference between the two groups was statistically significant(P<0.001).Conclusions:For patients after LDH,applying cognitive behavioral therapy combined with Pilates exercise could help to reduce the degree of kinesiophobia,promote the early recovery of lumbar function,and improve the compliance of postoperative patients with rehabilitation exercises.