UNASSIGNED: A total 177 elderly patients with OVCF were divided into rehabilitation group (n = 104) and control group (n = 73) according to whether they received psoas and abdominal muscle rehabilitation training for 3 months after PKP. The differences of general data, orthopaedic rehabilitation, prognosis and bone metabolism were compared between the two groups. All the patients were divided into compliance group (68 cases) and non-compliance group (36 cases) according to compliance. Orthopaedic rehabilitation indicators, prognostic indicators of PKP, and bone metabolism-related parameters were collected for analysis of Chi-square test and Logistic regression. ROC curve was used to analyze the predictive value of bone metabolism related indicators in the compliance of lumbar and abdominal muscle rehabilitation training.
UNASSIGNED: There was no significant difference in the general data between the rehabilitation training group and the control group (All p > 0.05). Compared with the control group, the Berg balance scale score was significantly increased, while the Visual Analogue Scale (VAS) score, Oswestry Disability Index (ODI) score and the proportion of new fractures were significantly decreased in the rehabilitation training group (All p < 0.05). Compared with the control group, the bone mineral density (BMD) T value, osteocalcin (OCN) and 25-hydroxyvitamin D (25 (OH) D) levels were significantly increased and the levels of type I N-propeptide (P1NP) and β-isomerized C-terminal telopeptides (β-CTX) were significantly decreased in the rehabilitation training group compared with the control group (All p < 0.05). Chi-square test and Logistic regression analysis showed that age > 75 years, severe anxiety, severe pain and postoperative complications were significantly associated with the compliance of psoas and abdominal muscle rehabilitation training in patients with OVCF after PKP. ROC curve analysis showed that BMD T value, OCN, P1NP, β-CTX, or 25-OH-D levels predicted the AUC of rehabilitation training compliance in patients with OVCF after PKP were 0.821, 0.835, 0.736, 0.715, and 0.748, respectively.
UNASSIGNED: Rehabilitation training of lumbar and abdominal muscles can significantly improve the efficacy of PKP, reduce the degree of osteoporosis and improve the prognosis of patients with OVCF. Age, anxiety, pain and postoperative complications were independent risk factors affecting the compliance of psoas and abdominal rehabilitation training in patients with OVCF after PKP.
■177例老年OVCF患者根据PKP术后是否接受腰大肌和腹肌康复训练3个月分为康复组(n=104)和对照组(n=73)。一般数据的差异,骨科康复,比较两组患者的预后及骨代谢情况。根据依从性分为依从性组(68例)和不依从性组(36例)。骨科康复指标,PKP的预后指标,收集骨代谢相关参数进行卡方检验和Logistic回归分析。采用ROC曲线分析骨代谢相关指标对腰腹肌康复训练依从性的预测价值。
■康复训练组与对照组的一般数据无显着性差异(均p>0.05)。与对照组相比,Berg平衡量表得分显著增加,而视觉模拟量表(VAS)评分,康复训练组Oswestry残疾指数(ODI)评分和新发骨折比例均明显降低(P均<0.05)。与对照组相比,骨密度(BMD)T值,与对照组相比,康复训练组的骨钙蛋白(OCN)和25-羟基维生素D(25(OH)D)水平显着升高,I型N-前肽(P1NP)和β-异构化C末端端肽(β-CTX)水平显着降低(均p<0.05)。卡方检验和Logistic回归分析显示,年龄>75岁,严重的焦虑,重度疼痛和术后并发症与PKP术后OVCF患者腰大肌和腹肌康复训练的依从性显著相关。ROC曲线分析显示BMDT值,OCN,P1NP,β-CTX,或25-OH-D水平预测PKP后OVCF患者康复训练依从性的AUC分别为0.821、0.835、0.736、0.715和0.748。
■腰腹肌康复训练可显著提高PKP的疗效,减轻OVCF患者骨质疏松程度,改善预后。年龄,焦虑,疼痛和术后并发症是影响OVCF患者PKP术后腰大肌和腹部康复训练依从性的独立危险因素。