Clinical Research Directory

Postoperative: Primary nurses provided disease and surgery education, guided pain self-assessment, assisted logrolling (every 2 h), and taught ankle pump exercises (3-4 times/day, 20-30 sets each time) to prevent DVT and straight leg raising (3 times/day, 5 min each time) to prevent nerve root adhesion. After drain removal, patients were taught brace wearing, standing posture correction, and gait/balance training.Discharge: A discharge education sheet was provided, instructing patients to avoid bending, weight-bearing, prolonged sitting, and cold exposure, and to lie on a firm mattress. At 3 weeks postoperatively, lumbar and back muscle exercises were taught.After discharge: Routine telephone follow-ups were conducted at 1 and 3 months, and patients were reminded to return for follow-up on time.

The intervention group received IMB model-based chain management for kinesiophobia after lumbar fusion. A 9-member multidisciplinary team (spine surgery, rehabilitation, psychology, pain) was formed to implement the protocol, adjust rehabilitation and analgesia, provide cognitive behavioral intervention, and collect data. During hospitalization, daily assessment triggered chain responses for refusal to move after 3 days, increased catastrophizing, pain NRS≥4 with fear, or failure to meet activity goals for 2 days. Responses included rehabilitation adjustment, psychological intervention within 24h, and analgesia adjustment. The vertical chain used the postoperative timeline (assessment-intervention-reassessment), with visual materials for older or less educated patients.