ACT联合量化功能锻炼在椎间盘突出症合并恐动症患者术后的应用

Application effect of acceptance and commitment therapy plus quantitative functional exercise in patients with intervertebral disc herniation concomitant with kinesiophobia after surgery

目的:探索接纳与承诺疗法(ACT)联合量化功能锻炼在椎间盘突出症(LDH)合并恐动症患者术后的应用效果。方法:选取2019年4月~2021年12月在合肥京东方医院择期手术的LDH合并恐动症患者84例为研究对象。采用随机数表法将患者分为观察组(n=41)和对照组(n=43),对照组采用常规护理模式,观察组在对照组的基础上采用ACT联合量化功能锻炼;观察两组患者干预后4、12周恐动症评估量表(TSK)、疼痛视觉模拟评分(VAS)、医院焦虑抑郁量表(HADS)、日本骨科协会评估治疗分数(JOA)、腰背-下肢功障碍评分(ODI)等指标。结果:干预后观察组患者术后4、12周TSK、VAS、HADS-A、HADS-D均低于对照组(P<0.05);干预后观察组患者术后4、12周JOA、ODI均优于对照组(P<0.05)。结论:ACT联合量化功能锻炼可改善LDH合并恐动症患者术后恐动、焦虑抑郁程度,降低患者疼痛水平,提高患者躯体功能。

Objective:To assess the application effect of acceptance and commitment therapy(ACT)plus quantitative functional exercise in patients with intervertebral disc herniation(LDH)concomitant with kinesiophobia after surgery.Methods:Eighty-four LDH patients concomitant with kinesiophobia treated by elective surgery in Hefei BOE Hospital were included from April 2019 to December 2021,and divided into observational group(n=41)and control group(n=43)by random number table.Patients in the control group just received conventional nursing procedure,and those in the observational group were ACT combined with quantitative functional exercise on the basis of the nursing in control group.Then the two groups were observed on the scoring on the Tampa Scale for Kinesiophobia(TSK),Visual Analogue Scale(VAS),Hospital Anxiety and Depression Scale(HADS),Japanese Orthopaedic Association Assessment Scale(JOA),and Oswestry disability index(ODI)at 4 and 12 weeks,respectively after surgery.Results:After the intervention,the TSK,VAS,HADS-A and HADS-D were lower,and JOA and ODI were better in the observational group than in the control group at 4 weeks and 12 weeks after operation(all P<0.05).Conclusion:ACT combined with quantitative functional exercise can improve postoperative anxiety and depression,reduce pain degree,and improve physical function of patients with LDH concomitant with kinesiophobia.