The Effect Of Multidisciplinary Cooperative Intervention On The Rehabilitation Outcome Of Lumbar Surgery Patients With Kinesiophobia

Objective1.To investigate the status and influencing factors of kinesiophobia in patients with lumbar disc herniation,in order to provide basis for clinical medical staff to formulate targeted intervention measures.2.To evaluate the effect of multidisciplinary intervention on the rehabilitation outcome of lumbar surgery patients with kinesiophobia.Methods1.A total of 428 patients with LDH were recruited and investigated by general questionnaire,Tampa Scale of Kinesiophbia(TSK),Visual analogue scale(VAS),General Self-Efficacy Scale(GSES),Hospital anxiety and depression scale(HADS).Single-factor and Logistic regression analysis was used for analyze the influencing factors.2.A total of 172 patients who were admitted to the department of spine surgery of the seventh medical center of the PLA general hospital from march to December 2017 and who were admitted to the department of spine surgery for the first time after lumbar fusion were selected as the study objects.The subjects who met the inclusion criteria were divided into experimental group and control group according to the random number table,with 86 cases in each group.The control group received routine intervention and follow-up.On the basis of the control group,the experimental group received the intervention formulated by spinal surgeons,anesthesiologists,rehabilitators,psychological counselors,nurses,nutritionists and other disciplines.Patients' kinesiophobia,lumbar spine rehabilitation and quality of life were evaluated 24 h after surgery,1 month,3 months,and 6 months after discharge,respectively.Results1.A total of 428 patients were enrolled,279 patients had symptoms of fear of movement,and the incidence rate was 65.19%.Logistics analysis results showed that the degree of pain(OR=6.973,95%CI:4.624~9.032),the self-efficacy(OR=0.637,95%CI:0.406~0.815),social support(OR=0.424,95%CI:0.375~0.692),anxiety&depression status(OR=0.651,95%CI:0.274~0.843)for patients with LDH may influence factors of movement disorder.2.The TSK score of the experimental group was significantly lower than that of the control group at each intervention time point,and the difference was statistically significant(p<0.001).There were statistically significant differences in JOA at 1,3 and 6 months(p<0.001).There was no statistically significant difference in sf-12 scores within 1 month(p>0.05),but there was statistically significant difference at 3 months and 6 months(p<0.001).Conclusion1.There was a high incidence of kinesiophobia among patients with lumbar disc herniation.Medical staffs should pay attention to the health education of patients LDH with kinesiophobia and improve their anxiety and depression psychology.In order to reduce the degree of HADS and promote the early rehabilitation and functional exercise,we should identify the symptoms of LDH and make individual intervention to improve their self-efficacy,and encourage their carers to pay more attention to the patients.2.Multidisciplinary intervention can reduce postoperative kinesiophobia,reduce disability,improve the outcome of rehabilitation and improve the quality of life of patients.