Development and application of a nursing care program for core muscle training for patients with lumbar disc herniation after endoscopic spine surgery

doi:10.3761/j.issn.0254-1769.2026.17.008

Abstract

Abstract:

Objective To develop a structured early core muscle training program for patients with lumbar disc herniation after transforaminal endoscopic spine surgery and to evaluate its effectiveness，thereby providing a reference for nursing practice. Methods Relevant evidence was systematically retrieved，appraised，and synthesized，and a structured early core muscle training program was developed through 2 rounds of Delphi expert consultation. The convenience sampling was used to recruit 120 patients with lumbar disc herniation who were admitted to the Department of Orthopedics of a tertiary grade A hospital in Anhui Province and underwent surgery between October， 2024 and December，2025 as study participants. Participants were randomly assigned to an intervention group or a control group using a random-number table，with 60 patients in each group. In addition to standardized routine postoperative rehabilitation guidance，the intervention group received the structured early core muscle training program. Formal training commenced 24 h after surgery and continued until 3 months postoperatively. The control group received standardized routine postoperative rehabilitation guidance. The visual analogue scale score for pain，modified Oswestry Disability Index score，Japanese Orthopaedic Association score，36-Item Short Form Health Survey composite score，and surface electromyographic parameters of the lumbar multifidus muscles were compared between the 2 groups within 24 h before surgery and at 3 months after surgery. Results The final structured early core muscle training program comprised 3 first-level indicators，9 second-level indicators，and 26 third-level indicators. All participants completed the 3-month follow-up. At 3 months after surgery，the intervention group had a lower visual analogue scale score and higher Japanese Orthopaedic Association score，36-Item Short Form Health Survey composite score，root mean square value normalized to maximum voluntary contraction[RMS（%MVC）]，and median frequency than the control group，with all between-group differences being statistically significant（all P<0.05）. Conclusion The structured early core muscle training program developed in this study may help reduce pain，promote lumbar functional recovery，improve health-related quality of life，and improve selected surface electromyographic parameters of the lumbar multifidus muscles in patients with lumbar disc herniation after transforaminal endoscopic spine surgery.

Key words: Lumbar Disc Herniation, Transforaminal Endoscopic Spine Surgery, Exercise Therapy, Rehabilitation Nursing, Postoperative Care, Quality of Life

摘要：

目的构建腰椎间盘突出症患者脊柱内镜术后核心肌群训练护理方案，并评价其应用效果，为临床护理实践提供参考。方法通过检索、评价和整合相关证据，并经2轮专家函询，构建核心肌群训练护理方案。采用便利抽样法，选取2024年10月—2025年12月在安徽省某三级甲等医院骨科住院并拟首次接受手术治疗的腰椎间盘突出症患者120例作为研究对象。采用随机数字表法，分为试验组和对照组，每组各60例。试验组在标准化常规术后康复指导基础上实施核心肌群训练护理方案，正式训练自术后24 h开始，持续至术后3个月；对照组接受标准化常规术后康复指导。比较两组术前24 h内及术后3个月的疼痛视觉模拟评分、删减版Oswestry功能障碍指数评分、日本骨科学会评分、36条目简明健康调查量表得分及腰椎多裂肌表面肌电图指标。结果形成包括3个阶段的核心肌群训练护理方案。两组均完成术后随访。术后3个月，试验组疼痛视觉模拟评分低于对照组，日本骨科学会评分、36条目简明健康调查量表得分及腰椎多裂肌表面肌电图最大自主收缩的标准化均方根值和中位频率均高于对照组，差异均有统计学意义（均P<0.05）。结论该研究构建的核心肌群训练护理方案有助于缓解腰椎间盘突出症患者脊柱内镜术后疼痛，促进腰椎功能恢复，改善健康相关生活质量及腰椎多裂肌部分表面肌电指标。

关键词: 腰椎间盘突出症, 椎间孔镜术, 运动疗法, 康复护理, 术后护理, 生活质量

MA Jie, ZHANG Li, LI Na, ZHU Kun, YE Yuchen, CHEN Yongxia. Development and application of a nursing care program for core muscle training for patients with lumbar disc herniation after endoscopic spine surgery[J]. Chinese Journal of Nursing, 2026, 61(17): 2358-2366.

马杰, 张丽, 李娜, 朱坤, 叶雨辰, 陈永侠. 腰椎间盘突出症患者脊柱内镜术后核心肌群训练护理方案的构建及应用[J]. 中华护理杂志, 2026, 61(17): 2358-2366.

Figures/Tables 5

Table 1 Contents of the nursing care program for core muscle training

Table 2 Comparison of baseline characteristics between the 2 groups

Table 3 Comparison of visual analogue scale scores between the 2 groups within 24 h before surgery and at 3 months after surgery[scores，M（P25，P75）]

Table 4 Comparison of modified Oswestry Disability Index scores，Japanese Orthopaedic Association scores，and 36-item Short-Form Health Survey composite scores between the 2 groups within 24 h before surgery and at 3 months after surgery（scores，$\overline{x}\pm s$）

Table 5 Comparison of surface electromyography indicators of the core muscles between the 2 groups within 24 h before surgery and at 3 months after surgery（$\overline{x}\pm s$）

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