Objective To investigate the influence of self-efficacy and postoperative pain on postoperative kinesiophobia in aged patients with femoral neck fractures and explore the mediating effect of self-efficacy on postoperative pain and kinesiophobia of the patients.Methods A total of 120 aged patients with femoral neck fractures were included in the study.A cross-sectional study was conducted using general questionaire,the rehabilitation self-efficacy scale,digital pain rating scale and Tampa scale for kinesiophobia.Pearson correlation was used to analyse the correlations between postoperative pain,self-efficacy and postoperative kinesiophobia.AMOS21.0 software was used to establish the mediating effect model of self-efficacy between postoperative pain and postoperative kinesiophobia.The mediating effect was verified by Bootstarp confidence interval evaluation.Results All 120 aged patients with femoral neck fractures completed the study.The score of postoperative kinesiophobia was(40.27±12.85).The level of kinesiophobia was negatively correlated with the self-efficacy score(r=-0.571,P<0.01),and positively with the level of postoperative pain(r=0.766,P<0.01).The direct standardized effect of postoperative pain on postoperative panic level was 0.367,the direct standardized effect of self-efficacy on postoperative panic level was-0.485,the direct standardized effect of postoperative pain on self-efficacy was-0.716,the indirect standardized effect of postoperative pain on postoperative panic level was 0.347,and the total standardized effect was 0.714,accounting for 48.60%of the total effect.Conclusions Postoperative pain can directly affect postoperative kinesiophobia or indirectly affect it via self-efficacy in elderly patients with femoral neck fractures.Medical staff should improve the self-efficacy of the aged patients by relieving the postoperative pain and alleviating the postoperative kinesiophobia.

Objective:To explore the effect of preoperative incentive spirometry combined with active cycle of breathing techniques (ACBT) training on pulmonary function recovery after scoliosis surgery in adolescents.Methods:From June 2019 to June 2021, random sampling was used to select 88 patients with scoliosis admitted to Beijing Chaoyang Hospital affiliated to Capital Medical University as the study subject. The patients were divided into a study group and a control group using a random number table method, with 44 patients in each group. The control group received preoperative ACBT training, while the study group conducted preoperative incentive spirometry combined with ACBT training. The respiratory function and blood gas indicators, including forced expiratory volume (FEV1) , forced vital capacity in one second (FVC) , vital capacity, and blood oxygen saturation (SpO 2) , were compared between the two groups before and two weeks after intervention. The Borg Scale and the Tilburg Frailty Indicator were used to evaluate the degree of dyspnea and physical frailty in the two groups of patients, and the incidence of complications and treatment satisfaction were compared between the two groups to analyze the effect of preoperative incentive spirometry combined with ACBT training on pulmonary function recovery after scoliosis surgery in adolescents. Results:Two weeks after operation, the FEV1/FVC ratio and SpO 2 in the two groups were lower than those before intervention, with a statistical difference ( P<0.05) ; The FEV1/FVC ratio and SpO 2 in the study group were statistically higher than those in the control group ( P<0.01) . The vital capacity of the control group decreased two weeks after operation compared to that before intervention, and the vital capacity of the study group was higher than that of the control group, with statistically significant differences ( P<0.05) . Two weeks after operation, the Borg Scale score of patients in both groups was higher than that before intervention, and that of the study group was lower than that of the control group, with statistically significant differences ( P<0.05) . There was no statistical difference in the incidence of postoperative complications between the two groups ( P>0.05) . The treatment satisfaction in the study group was 97.73% (43/44) , higher than 86.36% (38/44) in the control group, with a statistically significant difference ( P<0.05) . Conclusions:Preoperative incentive spirometry combined with ACBT training can promote postoperative pulmonary function recovery, alleviate frailty symptoms, and improve patient satisfaction in patients with scoliosis, which is worthy of clinical practice.

ObjectiveTo explore the effect of kinematic alignment on postoperative knee function for patients after total knee arthroplasty (TKA). MethodsFrom June, 2020 to October, 2021, 200 patients undergoing primary TKA in Beijing Chaoyang Hospital were divided into mechanical alignment (MA) group (n = 100) and kinematic alignment (KA) group (n = 100). All the patients accepted comprehensive rehabilitation after operation. They were assessed with Keen Society Score (KSS) before and three months after operation, with Visual Analogue Scale for pain (VAS) before, and three days and three months after operation. The time of first standing, the time of first straight-leg raising more than 30°, and the active range of motion (AROM) of knee before, and one, two and three days, and one and three months after operation were recorded, as well as where to go after discharge. ResultsA total of 96 patients in MA group and 98 in KA group finished the research. The AROM of knee improved more in the KA group than in the MA group after operation (F_group = 8.816, P = 0.017), and the incidence going to the rehabilitation institutes was less (χ² = 6.542, P = 0.011). ConclusionKA may promote the rapid recovery of AROM of knee for patients after TKA, and reduce the needs of institute-based rehabilitation after discharge, to save medical costs.