AIM: To investigate the behavioral outcomes in patients with lumbar spinal stenosis improved by systemic rehabilitation education in the perioperative period. METHODS: Sixty patients following operation for lumbar spinal stenosis were selected from the Department of Orthopaedics, Huludao Central Hospital from September 1998 to September 2003. They were randomly divided into observation group and control group with 30 patients in each group. All the patients received conventional treatment and nursing, and those in the observation group received rehabilitation education in addition. The rehabilitation education included: (1) psychological counseling, (2) individualized instruction: one-to-one guidance according to patients' actual state and answering their questions at any time, (3) propagandistic and educational lists for rehabilitation education: hospitalization propaganda, names of diseases, etiological and induced causes of diseases, clinical characteristics, body position, diet, preoperative and postoperative education, methods of functional rehabilitation, weight loading, states in the rehabilitative period and coping measures, which were explained in diagrammatic form, (4) demonstration and anti-demonstration: Instructors demonstrated the correct exercise methods for patients aiming at the lists for rehabilitation education by themselves, followed by requested anti-demonstration by patients, (5) education to important family members: the knowledge about rehabilitation were taught to them in order to assist their suffered family members to follow education plans, (6) evaluation of behavior: a uniform behavior rating schedule consisting of 4 parts: the first part was incidence of mental anxiety by assessing patients' various mental status in the form of interview or observational measure; the second part was incidence of the complications such as constipation, sore and urinary retention by measuring the actual number; the third part was correct rate of functional exercise by assessing whether the patients could attend to the needed exercise and the correct rate of exercise they had, which could be measured by observing the demonstration of raising straight legs, swallow-flying posture and 5-point posture; the fourth part was self-care ability of living by assessing patients' self-care ability in daily life including 6 grades: turning over their bodies by themselves, washing and brushing, weight-unloading walking, wearing socks and tying shoestrings by themselves, going upstairs and downstairs by support them with hands or by themselves, ranging from 0 to 20 marks, 4 marks different between two adjacent grades and higher marks meaning better self-care ability. RESULTS: According to the actual management, all the 60 patients were analyzed in the result. (1) The incidence of mental anxiety in the observation group was 47% (14/30) and 0 before and after treatment, and t hat in the control group was 43% (14/30) and 57% (17/30) before and after treatment. (2) The incidence of complications was lower in the observation group than in the control group (constipation, sore and urinary retention: 7% (2/30), 3% (1/30), 0 versus 67% (20/30), 50% (15/30), p < 0.01). (3) Correct rate of functional exercise was significantly higher in the observation group than in the control group (raising straight legs, swallow-flying posture and 5-point posture: all 100% in the observation group versus 67% (20/30), 60% (18/30), 27% (8/27) in the control group, p < 0.01). (4) Score of self-care ability of living was higher in the observation group than in the control group (13.73 +/- 3.59 marks versus 8.67 +/- 3.94 marks, p < 0.01). CONCLUSION: Systemic rehabilitation education can remarkably reduce the incidence of mental anxiety and complications in patients, increase the correct rate of functional exercise and enhance self-care ability of living.

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