基于遗忘曲线规律的前置化腰背肌功能锻炼模式在老年OLIF手术患者中的应用

Application of prepositional function excercise approach of paraspinal muscles based on forgetting curve in elderly patients undergoing OLIF surgery

目的探讨基于遗忘曲线规律的前置化腰背肌功能锻炼模式在老年OLIF手术患者中的应用效果。方法将2022年6月至2023年10月江南大学附属医院收治的80例老年腰椎椎管狭窄症OLIF手术患者,随机分为观察组和对照组(每组各40例)。对照组采用常规腰背肌功能锻炼模式,在术后3 d开展五点支撑法腰背肌锻炼指导;观察组将腰背肌功能锻炼指导前置于入院当天实施,同时指导患者根据遗忘曲线规律进行复习。比较两组患者术后腰背肌锻炼错误次数、锻炼依从性、自我效能感、改良腰腿痛患者报告结局(PRO)量表评分及Oswestry功能障碍指数(ODI)的差异。结果观察组术后5 d和1个月时五点支撑法锻炼错误次数低于对照组,骨科功能锻炼依从性量表评分和自我效能感量表评分均优于对照组,两组比较,差异有统计学差异(P<0.05);入院当天、术后5 d改良PRO量表评分和ODI两组相近(P>0.05),但术后1个月观察组上述指标均低于对照组(P<0.05)。结论将基于遗忘曲线规律的前置化腰背肌锻炼模式应用于老年OLIF手术患者,可有效增强功能锻炼准确度,提高依从性和自我效能感,改善临床症状和腰椎功能。

Objective To investigate the effect of prepositional paraspinal muscle function exercise mode based on forgetting curve in elderly patients undergoing OLIF surgery.Methods A total of 80 elderly patients with lumbar spinal stenosis treatedby OLIF in the Affiliated Hospital of Jiangnan University from June 2022 to October 2023,were randomly divided into observation group(n=40)and control group(n=40).Patients in control group received conventional paraspinal muscle exercises approach with the instruction of five-point support training method at 3 d after surgery,and patients in observation group advanced the guidance to the day of admission,and instructed the patients reviewing it based on forgetting curve.The times of exercise errors,exercise compliance,self-efficacy,modified patient reported outcome(PRO)scale score of back and leg pain and Oswestry disability index(ODI)after surgery were compared between the two groups.Results At 5 d and 1 month postoperatively,times of exercise errors of five-point support training method in observation group were lower than those in control group,scores of othopedics functional exercise compliance scale and self-efficacy scale were better than those of control group,there were statistical differences between the two groups(P<0.05).The modified PRO scale and ODI were similar on the day of admission and 5 d postoperatively(P>0.05),while at 1 months after surgery,the above parameters in the observation group were lower than those in control group(P<0.05).Conclusion With the application of prepostional paraspinal muscles function exercise approach based on forgetting curve,the accuracy of functional exercise could be effectively enhanced,the compliance and self-efficacy be increased,so as to improve clinical symptoms and lumbar function for elderly patients with OLIF.