Analysis of the effect of lumbar kinetic chain training under accelerated rehabilitation surgical program on postoperative rehabilitation of patients with lumbar disc herniation

WU Chun-hong; LIU Ting-ting; CHE Xiao-wen; XU Pei-rong; ZHU Lin-yi; XU Juan

doi:10.3969/j.issn.2095-252X.2025.07.014

Abstract：Objective To investigate the effect of lumbar kinetic chain training program under accelerated rehabilitation surgery(ERAS)program on rehabilitation after percutaneous endoscopic lumbar discectomy(PELD)in patients with lumbar disc herniation(LDH).Methods Seventy-two LDH patients treated with PELD between April 2022 and October 2023 were selected from our hospital.The patients were divided into a control group and an observation group,36 cases each,according to the random number table method.The same ERAS protocol was implemented in the perioperative period in both groups.Postoperatively,the control group implemented conventional rehabilitation training,and the observation group implemented the lumbar power chain training program.The visual analog scale(VAS)score was used to assess the patients'pain level;the Oswestry Disability Index(ODI)score and the Japanese Orthopaedic Association(JOA)score were used to assess the patients'lumbar spine function;the Hamilton Anxiety Scale(HAMA)score and the Hamilton Depression Scale(HAMD)score were used to assess the patients'anxiety and depressive symptoms;the Activities of Daily Living(ADL)score and World Health Organization Brief Quality of Life Questionnaire(WHOQOL-BREF)scores were used to assess the patients'ability to perform daily activities and quality of life;and the modified MacNab criteria were used to assess the patients'efficacy.Results At 3 days,1 month,2 months,3 months,4 months,5 months and 6 months postoperatively,the VAS scores of patients in the observation group were lower than those of patients in the control group(P<0.05).At 1,3 and 6 months postoperatively,ODI scores,HAMA scores and HAMD scores of patients in the observation group were lower than those of patients in the control group(P<0.05),and JOA,ADL scores and WHOQOL-BREF scores were higher than those of patients in the control group(P<0.05).At 6 months postoperatively,the excellent rate of patients in the observation group was higher than that of patients in the control group(97.2%vs.83.3%,P=0.047).Conclusions The lumbar chain-of-motion training model under the ERAS protocol provides better relief of post-PELD pain,and improves patients'lumbar spine function,anxiety,depression,and quality of life.