Longitudinal study on compliance of out-of-hospital functional exercise in patients with lumbar disc herniation undergoing conservative treatment
10.3760/cma.j.cn115682-20211121-05239
- VernacularTitle:腰椎间盘突出症保守治疗患者院外功能锻炼依从性变化的纵向研究
- Author:
Caixiang GAO
1
;
Lin MA
;
Xueyan HUANG
;
Jingying ZHANG
Author Information
1. 浙江中医药大学附属杭州市中医院推拿科,杭州 310007
- Keywords:
Lumber disc herniation;
Rehabilitation exercise;
Compliance curve;
Influencing factors
- From:
Chinese Journal of Modern Nursing
2022;28(29):4032-4038
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the longitudinal changes and influencing factors of out-of-hospital functional exercise compliance in patients with lumbar disc herniation treated conservatively based on patient-based compliance curve (PBCC) .Methods:From April to September 2020, the convenient sampling method was used to select 88 patients with lumbar disc herniation treated conservatively in Hangzhou Hospital of Traditional Chinese Medicine as the research objects. The score of out-of-hospital functional exercise compliance questionnaire of patients with lumbar disc herniation was measured from the time of discharge, once every 2 weeks, and the PBCC of functional exercise was drawn after continuous measurement to the 24th week , taking time as independent variable ( x) and functional exercise compliance index as dependent variable ( y) . Univariate and multiple linear regression analyses were used to explore the influencing factors of 24-week compliance index. A total of 88 questionnaires were distributed, among which 3 patients withdrew due to surgery and 11 patients were lost to follow-up. A total of 74 valid questionnaires were finally recovered, with an effective recovery rate of 84.09% (74/88) . Results:Within 24 weeks of discharge, the PBCC formula of the total functional exercise score of patients was y=0.005 x3-0.196 x2+1.436 x+59.197 ( R2=0.898, F=26.517, P<0.01) . The PBCC formula of physical exercise was y=0.008 x3-0.337 x2+3.616 x+56.153 ( R2=0.878, F=21.570, P<0.01) . The formula of exercise effect supervision PBCC was y=-0.006 x3+0.309 x2-5.315 x+76.371 ( R2=0.910, F=30.458, P<0.01) . The PBCC formula of actively seeking advice was y=0.012 x3-0.460 x2+3.931 x+44.071 ( R2=0.865, F=19.217, P<0.01) . Except for the PBCC of effect supervision, the changes of other PBCC showed a trend of first increasing and then decreasing. The average compliance index in 24 weeks was (57.73±8.20) , the high peak appeared in the 4th week and the index was (64.08±8.91) . The low peak appeared in the 18th week and the index was (52.42±7.81) . The results of univariate analysis showed that there were statistically significant differences in the compliance level of rehabilitation exercise in patients with lumbar protrusion in different age, education level, course of lumbar protrusion, pain degree, accompanying symptoms, functional exercise methods and disease knowledge ( P<0.05) . The results of multiple linear regression analysis showed that the main influencing factors of functional exercise compliance of patients were disease knowledge, pain degree, course of lumbar protrusion and functional exercise method ( P<0.05) . Conclusions:The functional exercise compliance of lumbar disc herniation patients shows a horizontal "S" -like dynamic change. During the period of decreased compliance, regular rehabilitation guidance and health education, pain management and prevention of recurrence are necessary measures to improve functional exercise compliance of patients.