Controversial Outcomes in Neck Rehabilitation between Surgically and Conservatively Treated Patients—Results of an Observational Study

Abstract

The present study aimed to compare changes during inpatient rehabilitation between conservatively and surgically treated patients. A total of n = 162 patients with cervical spine complaints were included in the study (n = 107 conservatively treated, n = 55 after surgery). Patients completed disease-specific (NDI) and generic (NPRS, EQ-5D-5L, HAQ) patient reported outcome measures (PROMs) before and after rehabilitation. In addition, the range of motion (ROM) in the transversal plane of the cervical spine was measured. Changes and correlations between PROMs and ROM values during rehabilitation were assessed. The influence of moderating factors on NDI outcomes was examined. Significant improvements with large effect sizes were found in PROMs and ROM (all p < 0.001). The conservatively treated patients showed significantly greater NDI improvements than operated patients (p = 0.050), but a greater proportion of poor performance in ROM (p = 0.035). Baseline NDI (β = 0.66), HAQ (β = 0.14), and ROM scores (β = −0.17) explained 63.7% of the variance in NDI after rehabilitation. Both patient groups showed different outcomes. The findings of this study indicate that the unique needs of patients may require different therapeutic interventions and highlight the importance of using multidimensional outcome measures when implementing a multimodal rehabilitation approach.

Mentalizing and epistemic trust as critical success factors in psychosomatic rehabilitation: results of a single center longitudinal observational study

“…Since we found a substantial variation in mentalizing at baseline, the performance score (T2D) was used in the SEM model. The T2D is a simple method to correct for baseline differences (46), which allows to use baseline corrected variables in SEM models and has been shown to facilitate interpretability in various fields of rehabilitation research (42,43,47,48). Moreover, we investigated additional factors that may be associated with the improvement of mentalizing in psychosomatic rehabilitation.…”