腰椎间盘突出症患者术后恐动症与功能康复的相关性研究

Relationship between postoperative kinesiophobia and functional recovery in patients with lumbar disc herniation

目的 探讨腰椎间盘突出症(lumbar disc herniation, LDH)患者术后恐动症与康复结局之间的相关性。方法 本研究为横断面调查研究。连续性纳入2019年6月—10月在四川大学华西医院因LDH行腰椎间盘摘除术的患者。根据恐动症Tampa评分表(Tampa Scale for Kinesiophobia, TSK)评分将患者分为恐动症组和无恐动症组。于不同时间点收集患者的TSK评分、疼痛视觉模拟评分法(Visual Analogue Scale, VAS)评分、Oswestry下腰痛功能障碍指数(Oswestry Disability Index, ODI)和日本骨科协会评估治疗分数(Japanese Orthopaedic Association Scores, JOA)。分析患者术后恐动症与疼痛、腰椎功能的关系。结果 共纳入患者201例。其中,恐动症组128例,无恐动症组73例,恐动症发生率为63.68%。Pearson相关性检验分析结果显示,TSK评分在术后24 h时分别与VAS评分(r=0.218,P<0.01)、ODI评分(r=0.263,P<0.01)呈正相关;在术后1个月时与VAS评分(r=0.296,P<0.01)呈正相关,与JOA评分呈负相关(r=-0.182,P<0.05)。多重线性回归分析结果显示,术后年龄、疼痛、腰椎功能与术后恐动症相互影响(P<0.05)。结论 LDH患者术后24 h恐动症发生率较高。术后恐动症与LDH患者的康复结局相关。

Objective To explore the correlation between postoperative kinesiophobia and rehabilitation outcome in patients with lumbar disc herniation(LDH).MethodsThis study was a cross-sectional survey.The patients who underwent lumbar discectomy due to LDH in West China Hospital of Sichuan University between June and October 2019 were included consecutively.According to the Tampa Scale for Kinesiophobia(TSK)score,patients were divided into two groups:the kinesiophobia group and the non-kinesiophobia group.The patients'scores of the TSK,the Visual Analogue Scale(VAS),the Oswestry Disability Index(ODI),and the Japanese Orthopaedic Association Scores(JOA)at different time points were collected.The relationship between postoperative kinesiophobia,pain,and lumbar function in patients was analyzed.Results A total of 201 patients were included.Among them,there were 128 cases in the kinesiophobia group and 73 cases in the non-kinesiophobia group.The incidence of kinesiophobia was 63.68%.Pearson correlation test analysis showed that TSK score was positively correlated with VAS score(r=0.218,P<0.01)and ODI score(r=0.263,P<0.01)at 24 h after surgery.At one month after surgery,there was a positive correlation with VAS score(r=0.296,P<0.01)and a negative correlation with JOA score(r=-0.182,P<0.05).The results of multiple linear regression showed that postoperative age,pain,lumbar function,and postoperative kinesiophobia were interrelated(P<0.05).Conclusions Patients with LDH had a higher incidence of kinesiophobia 24 h after surgery.Postoperative kinesiophobia was correlated with the recovery outcome of patients with LDH.