不稳定支撑面核心稳定锻炼对骨质疏松性椎体骨折患者康复效果的影响

Effect of core stabilization exercise with unstable support surface on rehabilitation of patients with osteoporotic vertebral fracture

目的分析不稳定支撑面核心稳定锻炼对骨质疏松性椎体骨折患者康复效果的影响。方法选取2018年1月-2020年1月郑州大学第五附属医院的66例骨质疏松性椎体骨折患者为研究对象,所有患者均采用经皮穿刺椎体成形术治疗,术后采用随机数字表法将其分为干预组和对照组,每组33例。两组均给予术后常规康复干预,干预组同时给予不稳定支撑面核心稳定锻炼干预,比较两组患者术前1 d和康复训练后1 d的椎体高度、形态、稳定性和步态。结果两组患者的性别、年龄、损伤椎体、骨质疏松病程、受教育年限和婚姻状况差异无统计学意义(P>0.05)。术前两组的伤椎前缘高度比、伤椎中部高度比、后凸Cobb角、睁眼轨迹长、闭眼轨迹长、Romberg率、单位时间睁眼轨迹长、单位时间闭眼轨迹长、单位时间Romberg率、睁眼X轴重心中心偏差、闭眼X轴重心中心偏差、睁眼Y轴重心中心偏差、闭眼Y轴重心中心偏差、跨步长、步频、舒适步速组间差异均无统计学意义(P>0.05)。训练后,干预组的伤椎前缘高度比[(79.26±12.15)%vs.(72.26±13.36)%]、伤椎中部高度比[(82.11±10.26)%vs.(75.64±9.56)%]、后凸Cobb角[(9.87±7.10)vs.(14.41±2.36)°]、闭眼轨迹长[(1856.29±457.16)vs.(2358.48±786.45)mm]、Romberg率[(1.32±0.29)%vs.(1.87±0.54)%]、单位时间闭眼轨迹长[(33.45±3.26)vs.(41.55±4.69)mm]、单位时间Romberg率[(1.41±0.30)%vs.(1.95±0.77)%]、睁眼X轴重心中心偏差[(11.06±1.36)vs.(16.54±2.22)mm]、闭眼X轴重心中心偏差[(11.15±0.96)vs.(23.31±3.06)mm]、睁眼Y轴重心中心偏差[(12.57±1.84)vs.(15.56±2.06)mm]、闭眼Y轴重心中心偏差[(15.69±2.05)vs.(18.96±3.56)mm]、跨步长[(0.57±0.12)vs.(0.49±0.10)m]、步频[(1.09±0.29)vs.(0.94±0.20)步/s]、舒适步速[(0.35±0.12)vs.(0.29±0.10)m/s]优于对照组(P<0.05)。两组的睁眼轨迹长和单位时间睁眼轨迹长差异无统计学意义(P>0.05)。结论骨质疏松性椎体骨折患者术后在常规康复干预的基础上联合不稳定支撑面核心稳定锻炼能够有效恢复椎体高度和形态,一定程度上改善稳定性和步态。

Objective To analyze the effect of core stabilization exercise with unstable support surface on rehabilitation of patients with osteoporotic vertebral fracture.Methods From January 2018 to January 2020,66 patients with osteoporotic vertebral fractures in the Fifth Affiliated Hospital of Zhengzhou University were selected as the research objects.All patients were treated with percutaneous vertebroplasty.After operation,they were randomly divided into intervention group and control group by random number table method,with 33 cases in each group.Both groups were given routine rehabilitation intervention after operation,while the intervention group was given core stabilization exercise with unstable support surface at the same time.The vertebral height,shape,stability and gait of the two groups were compared 1 day before operation and 1 day after rehabilitation training.Results There was no significant difference in gender,age,injured vertebral body,course of osteoporosis,years of education and marital status between the two groups(P>0.05).Before surgery,there was no statistically significant difference in the height ratio of the front edge of the injured vertebra,middle height ratio of the injured vertebra,back convex Cobb angle,track length when eyes were open,track length when eyes were closed,Romberg rate,track length per unit time when eyes were open,track length per unit time when eyes were closed,Romberg rate per unit time,deviation of the center of gravity on X-axis when eyes were open,deviation of the center of gravity on X-axis when eyes were closed,deviation of the center of gravity on Y-axis when eyes were open,deviation of the center of gravity on Y-axis when eyes were closed,stride length,step frequency or comfortable pace between the two groups(P>0.05).After training,the height ratio of the front edge of the injured vertebra[(79.26±12.15)%vs.(72.26±13.36)%],middle height ratio of the injured vertebra[(82.11±10.26)%vs.(75.64±9.56)%],back convex Cobb angle[(9.87±7.10)vs.(14.41±2.36)°],track length when eyes were closed[(1856.29±457.16)vs.(2358.48±786.45)mm],Romberg rate[(1.32±0.29)%vs.(1.87±0.54)%],track length per unit time when eyes were closed[(33.45±3.26)vs.(41.55±4.69)mm],Romberg rate per unit time[(1.41±0.30)%vs.(1.95±0.77)%],deviation of the center of gravity on X-axis when eyes were open[(11.06±1.36)vs.(16.54±2.22)mm],deviation of the center of gravity on X-axis when eyes were closed[(11.15±0.96)vs.(23.31±3.06)mm],deviation of the center of gravity on Y-axis when eyes were open[(12.57±1.84)vs.(15.56±2.06)mm],deviation of the center of gravity on Y-axis when eyes were closed[(15.69±2.05)vs.(18.96±3.56)mm],stride length[(0.57±0.12)vs.(0.49±0.10)m],step frequency[(1.09±0.29)vs.(0.94±0.20)step/s]and comfortable pace[(0.35±0.12)vs.(0.29±0.10)m/s]of the intervention group were better than those of the control group(P<0.05).There was no significant difference in the track length when eyes were open or track length per unit time when eyes were open between the two groups(P>0.05).Conclusion In patients with osteoporotic vertebral body fractures,core stabilization exercise with unstable support surface on the basis of conventional rehabilitation interventions after surgery can effectively restore the height and shape of the vertebral body,and improve the stability and gait to a certain extent.