基于目标管理法的阶段性康复训练在脊柱骨折患者术后康复中的应用

Application of phased rehabilitation training based on goal management method in postoperative rehabilitation of spinal fracture patients

目的观察基于目标管理法的阶段性康复训练对脊柱骨折患者术后康复进程及椎体功能的影响。方法本研究为前瞻性研究,选择中国人民解放军联勤保障部队第九八九医院2021年5月至2022年5月收治的100例脊柱骨折患者为研究对象,通过计算机采用随机分组法将其分为常规组(50例)和试验组(50例),常规组实施常规康复训练,试验组实施基于目标管理法下的阶段性康复训练,2组均开展为期1年随访,比较2组患者的椎体结构、椎体功能改善情况,并发症发生情况及康复进程。结果在不同训练模式下,试验组1个月后的伤椎后凸角、Cobb角度分别为(16.2±3.2)°、(13.7±3.1)°,均低于常规组[(18.6±3.3)°、(15.8±3.2)°];3个月后的伤椎后凸角、Cobb角度分别为(13.3±3.3)°、(10.2±2.8)°,均低于常规组[(15.4±3.3)°、(12.4±3.4)°];试验组1个月后、3个月后的Oswestry功能障碍指数(ODI)评分分别为(35.3±5.3)分、(30.4±5.5)分,均低于常规组[(38.5±5.4)分、(34.7±5.3)分];试验组1个月后、3个月后的日本骨科协会治疗分数(JOA)评分分别为(20.7±5.3)分、(24.2±5.3)分,均高于常规组[(18.4±3.3)分、(21.3±5.2)分];试验组术后并发症发生率10.0%(5/50)低于常规组24.0%(12/50);试验组的住院时间、卧床时间、骨折愈合时间分别为(10.3±2.4)d、(45.2±10.4)d、(85.2±10.4)d,均低于常规组[(12.3±3.6)d、(50.6±10.7)d、(90.4±10.5)d],差异均具有统计学意义(P<0.05)。结论基于目标管理法下的阶段性康复训练能促进脊柱骨折患者的椎体结构、功能恢复,对降低术后并发症发生风险、加快康复进程均有积极意义。

Objective To observe the impact of phased rehabilitation training based on goal management method on the postoperative rehabilitation process and vertebral function of patients with spinal fractures.Methods This study is a prospective study that selected 100 patients with spinal fractures admitted between May 2021 and May 2022 as the study subjects.They were randomly divided into a conventional group(50 cases)and an experimental group(50 cases)using computer randomization.The conventional group received routine rehabilitation training,while the experimental group received phased rehabilitation training based on goal management.Both groups were followed up for one year to compare the improvement of vertebral structure and function,the occurrence of complications,and the recovery process.Results Under different training modes,the posterior convex angle and Cobb angle of the injured vertebrae in the experimental group after one month were(16.2±3.2)°and(13.7±3.1)°,respectively,which were lower than those in the conventional group[(18.6±3.3)°and(15.8±3.2)°].After 3 months,the posterior convex angle and Cobb angle of the injured vertebra were(13.3±3.3)°and(10.2±2.8)°,respectively,which were lower than those in the conventional group[(15.4±3.3)°and(12.4±3.4)°].The ODI scores of the experimental group after 1 month and 3 months were(35.3±5.26)points and(30.4±5.5)points,respectively,which were lower than those of the conventional group[(38.5±5.4)points and(34.7±5.3)points].The JOA scores of the experimental group after 1 month and 3 months were(20.7±5.3)points and(24.2±5.3)points,respectively,which were higher than those of the conventional group[(18.4±3.3)points and(21.3±5.2)points].The incidence of postoperative complications in the experimental group was 10.00%(5/50),which was lower than that in the conventional group[24.0%(12/50)].The hospitalization time,bed rest time,and fracture healing time of the experimental group were(10.3±2.4)days,(45.2±10.4)days,and(85.2±10.4)days,respectively,which were lower than those of the conventional group[(12.3±3.6)days,(50.6±10.7)days,and(90.4±10.5)days](P<0.05).Conclusion The phased rehabilitation training based on the goal management method can promote the recovery of vertebral structure and function in patients with spinal fractures,and has positive significance in reducing the risk of postoperative complications and accelerating the rehabilitation process.