摘要
目的评价智能手机对腰椎术后患者远程康复训练依从性的判断效力。方法选取28例腰椎手术3个月以上的异地患者,患者在有视频监控的康复室中通过智能手机客户端进行远程康复训练。康复计划由15个小节组成,每小节训练完成后患者需点击相应按钮进行反馈,两次点击之间的时间为患者单节训练的实际时间(Ta),视频时长为单节训练的理论时间(Tt),计算二者的时间差Td(Ta–Tt)及时差比Tr([Ta–Tt)/Tt]。同期康复医生通过查阅监控视频对每节患者的依从性进行评判,然后评价智能手机Td和Tr值对患者依从性的判断效力。结果共收集420小节有效信息,其中依从组327个小节、非依从组93个小节。非依从组Td、Tr值显著高于依从组(P <0.05)。其中Td值可以更好地判断患者的依从性(P <0.05),AUROC值为0.976(95%CI,0.955～0.997);当诊断界值为7 s时,敏感度为0.964(95%CI,0.932～0.981),特异度为0.981(95%CI,0.921～1.000)。40岁以下、40岁及以上两个年龄亚组Td值比较,差异无统计学意义(P>0.05)。结论智能手机可用于监测腰椎术后患者远程康复训练依从性,应用Td可取得良好的判断效力,且其不受年龄因素影响。
Objective To evaluate the effectiveness rehabilitation system in monitoring patient complimace of of judgement remote-distmace on e-health, a smartphone-based rehabilitation training after lumbar surgery. Methods A total of 28 nonlocal patients treated by lumbar surgery for more than 3 months were enrolled in the study. They were invited into a rehabilitation monitored wards, mad were trained following therehabilitation software through the client of the smartphone. The rehabilitation schedule comprised of 15 sections, for each section, patients＇ actual exercise time （Ta） and theoretical time （Tt） were recorded by the system, after that, time difference （Td） and relative time difference （Tr） were calculated as follows： Td = Ta - Tt, Tr = （Ta Tt）/Tt. The rehabilitation doctors judged the compliance of each patient by consulting the surveillance video at the same period. Results Valid information of 420 sections was collected, 327 of which were complied and 93 were non-complied. The Td and Tr values were significantly higher in non-complied sections than complied sections （both P 〈0.05）, in which Td value was found significantly better in evaluating the compliance of patients （P 〈0.05）, with AUROC value of 0.976 （95% CI, 0.955-0.997）. When the cutoff value for Td was set as 7 s, the sensitivity and specificity was 0.964 （95% CI, 0.932-0.981） and 0.981 （95% CI, 0.921-1.000） respectively. There was no statistic difference of Td value between patients younger than 40 and older than or equal to 40 （P 〉0.05）. Conclusions The smaJctpone can be used to predict patient compliance of remote-distance rehabilitation training after lumbar surgery; application of Td value has good efficacy of judgement which is not to be influenced by age factor
作者
侯景义
汤毅勇
李玉希
王鹏
杨睿
沈慧勇
HOU Jingyi;TANG fiyong;LI fuxi;WANG Peng;fANG Rui;SHEN Huiyong(Department of Orthopedics Sun fat-sen Memorial Hospital,Sun fat-sen University,Guangzhou,Guangdong 510120,China)
出处
《中国骨科临床与基础研究杂志》
2018年第3期140-145,共6页
Chinese Orthopaedic Journal of Clinical and Basic Research
基金
广东省医学科学技术研究基金项目(2016215144650110)
关键词
智能手机
腰椎手术
远程医学
康复
依从性
SmaJctphone
Lumbar surgery
Telemedicine
Rehabilitation
Compliance
