| Objective1.To design and apply musical rehabilitation exercises for patients with lumbar disc herniation after percutaneous transforaminal endoscopic discectomy and provide standard rehabilitation techniques for spine surgeries.2.To investigate the effect of music rehabilitation exercises on lumbar dysfunction,low back pain and sensory activity,clinical efficacy,and psychosocial status of lumbar protrusion in patients with lumbar disc herniation after percutaneous transforaminal endoscopic discectomy.MethodsAdopting the method of literature review,based on the knowledge of rehabilitation exercises,according to the pathophysiological changes of lumbar disc herniation,and combined with the activity ability of postoperative patients,the musical rehabilitation exercises were designed.randomized,single-blind,controlled trials were used for the study.The 56 patients who met the inclusion criteria were divided into intervention and control groups according to the random number table in a 1:1 ratio.The control group received routine rehabilitation nursing during hospitalization and routine rehabilitation exercises after discharge.The intervention group performed routine rehabilitation nursing during hospitalization same as the control group,after discharge,rehabilitation exercises were continued according to the intervention program of music rehabilitation exercises.The intervention time was 12 weeks.At the time of enrollment,4,8,and 12 weeks postoperatively,the Oswestry Disability Index Questionnaire(ODI),the Japanese Orthopaedic Association(JOA)scoring system,the Beck Anxiety Inventory(BAI)were used to evaluate the degree of lumbar dysfunction,low back pain and sensory activity and the psychosocial status.Clinical efficacy of lumbar protrusion was evaluated at 12 weeks postoperatively by the modified Macnab efficacy evaluation criteria.Results1.General information:Among the 51 patients who completed the study,25 were in the intervention group and 26 in the control group;males accounted for 64.7%and females accounted for 35.3%of these patients,indicating higher proportion of males;the mean age was(42.24±14.05)years;non-urban patients accounted for 66.7%of these patients,which is 2 folds the proportion of urban patients.There were no statistically significant differences between the two groups in the disease-related characteristics including herniation direction,herniated segment,whether with lumbar spinal stenosis,and whether with comorbidities(hypertension,diabetes,heart disease),or in any other general characteristics(P>0.05).2.Lumbar dysfunction:The total ODI scores at 4 weeks,8 weeks and 12 weeks after surgery in two groups were decreased to different degrees compared with that at enrollment.By 12 weeks after the operation,ODI of both groups did not reach the lowest score.Repeated measures analysis of variance showed that there was a time effect in this study.The ODI scores of the two groups were different at each time,and the recovery speed was different.At 4 weeks after surgery,there was statistical difference between the intervention group and the control group(P<0.05);At 8 weeks after surgery,the difference between the intervention group and the control group was remarkable statistically significant(P<0.01);At 12 weeks after surgery,the difference between the intervention and control groups remained statistically significant(P<0.05).3.Low back pain and sensory activity;The total JOA scores at 4 weeks,8 weeks and 12 weeks after surgery in two groups were decreased to different degrees compared with that at enrollment.Repeated measures analysis of variance showed that there was a time effect in this study.There were differences in JOA scores of the two groups at each time,and there has difference in the speed of recovery.At 4 weeks postoperatively,the difference was not statistically significant(P>0.05);At 8 weeks postoperatively,the difference was remarkable statistically significant(P<0.01);At 12 weeks postoperatively,the difference was statistically significant(P<0.05).Statistical analysis of the three dimensions showed that:(1)There were no significant differences in subjective symptoms at all postoperative time points(P>0.05).(2)There were significant differences in clinical signs at 4 and 8 weeks postoperatively(P<0.05).There was no significant difference at 12 weeks(P>0.05).(3)The differences of limited daily activities at each time point were statistically significant,and the difference was remarkable statistically significant at 8 weeks postoperatively(P<0.01).4.Psychosocial statusThere was a lower degree of anxiety in the intervention group and the control group.With the change of time,the BAI scores of the subjects in both groups showed a significant downward trend.There was no significant difference at 4 weeks(P>0.05)and 8 weeks(P>0.05)after surgery.The difference was statistically significant at 12 weeks(P<0.05).5.Clinical efficacy of lumbar protrusionAfter 12 weeks of intervention,the excellent and good rate in the intervention group was higher than that in the control group,and the difference was statistically significant(P<0.05).ConclusionMusical rehabilitation exercises can reduce the degree of lumbar vertebral dysfunction and influence of sensory activity;improve the psychosocial status and clinical efficacy of lumbar disc herniation after prcutaneous transforamina endoscopic discectomy. |
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