Importance of the Back-Café Concept to Rehabilitation After Lumbar Spinal Fusion: A Randomized Clinical Study With a 2-Year Follow-Up

Christensen, Finn Kjær; Laurberg, Ida; Bünger, Cody

doi:10.1097/01.brs.0000097890.96524.a1

Cited by 97 publications

(127 citation statements)

References 32 publications

Supporting

Mentioning

118

Contrasting

Unclassified

Order By: Relevance

“…In addition to our own observations in a randomised controlled trial [2], a previous study showed the importance of post-operative rehabilitation for the outcome of lumbar fusion [4]. In both trials, biopsychosocially orientated rehabilitation was more effective than exercise therapy in improving functional outcome [2,4].…”

Section: Introductionsupporting

confidence: 56%

Leg pain and psychological variables predict outcome 2–3 years after lumbar fusion surgery

2011

View full text Add to dashboard Cite

Prediction studies testing a thorough range of psychological variables in addition to demographic, workrelated and clinical variables are lacking in lumbar fusion surgery research. This prospective cohort study aimed at examining predictions of functional disability, back pain and health-related quality of life (HRQOL) 2-3 years after lumbar fusion by regressing nonlinear relations in a multivariate predictive model of pre-surgical variables. Before and 2-3 years after lumbar fusion surgery, patients completed measures investigating demographics, work-related variables, clinical variables, functional self-efficacy, outcome expectancy, fear of movement/(re)injury, mental health and pain coping. Categorical regression with optimal scaling transformation, elastic net regularization and bootstrapping were used to investigate predictor variables and address predictive model validity. The most parsimonious and stable subset of pre-surgical predictor variables explained 41.6, 36.0 and 25.6% of the variance in functional disability, back pain intensity and HRQOL 2-3 years after lumbar fusion. Pre-surgical control over pain significantly predicted functional disability and HRQOL. Pre-surgical catastrophizing and leg pain intensity significantly predicted functional disability and back pain while the pre-surgical straight leg raise significantly predicted back pain. Postoperative psychomotor therapy also significantly predicted functional disability while pre-surgical outcome expectations significantly predicted HRQOL. For the median dichotomised classification of functional disability, back pain intensity and HRQOL levels 2-3 years post-surgery, the discriminative ability of the prediction models was of good quality. The results demonstrate the importance of pre-surgical psychological factors, leg pain intensity, straight leg raise and postoperative psychomotor therapy in the predictions of functional disability, back pain and HRQOL-related outcomes.

show abstract

Section: Introductionsupporting

confidence: 56%

Leg pain and psychological variables predict outcome 2–3 years after lumbar fusion surgery

2011

View full text Add to dashboard Cite

show abstract

“…To imitate the session structure in the exercise group and thereby the potential effect of being in a group [25], patients met in a 'café-like' environment which provided the opportunity to exchange personal experiences of pain and physical incapacity. They met in groups of up to a maximum of 10 people once every second week for 10 weeks for a session of 45 minutes where they engaged in unstructured talk with a physiotherapist present.…”

Section: Methodsmentioning

confidence: 99%

Rest versus exercise as treatment for patients with low back pain and Modic changes. a randomized controlled clinical trial

Jensen

Leboeuf‐Yde

Wedderkopp

et al. 2012

BMC Med

View full text Add to dashboard Cite

BackgroundClinical experience suggests that many patients with Modic changes have relatively severe and persistent low back pain (LBP), which typically appears to be resistant to treatment. Exercise therapy is the recommended treatment for chronic LBP, however, due to their underlying pathology, Modic changes might be a diagnostic subgroup that does not benefit from exercise. The objective of this study was to compare the current state-of-the art treatment approach (exercise and staying active) with a new approach (load reduction and daily rest) for people with Modic changes using a randomized controlled trial design.MethodsParticipants were patients from an outpatient clinic with persistent LBP and Modic changes. They were allocated using minimization to either rest therapy for 10 weeks with a recommendation to rest for two hours daily and the option of using a flexible lumbar belt or exercise therapy once a week for 10 weeks. Follow-up was at 10 weeks after recruitment and 52 weeks after intervention and the clinical outcome measures were pain, disability, general health and global assessment, supplemented by weekly information on low back problems and sick leave measured by short text message (SMS) tracking.ResultsIn total, 100 patients were included in the study. Data on 87 patients at 10 weeks and 96 patients at one-year follow-up were available and were used in the intention-to-treat analysis. No statistically significant differences were found between the two intervention groups on any outcome.ConclusionsNo differences were found between the two treatment approaches, 'rest and reduced load' and 'exercise and staying active', in patients with persistent LBP and Modic changes.Trial RegistrationClinicalTrials.gov: NCT00454792

show abstract

“…There is widespread agreement throughout this literature that patients do not know what they should or should not do during recovery from surgery [7,18] There is little evidence for any post-operative restrictions (Table 1). There is strong evidence that activity is not harmful, together with theoretical arguments and considerable circumstantial evidence that progressive activity is beneficial (Table 2).…”

Section: Literature Reviewmentioning

confidence: 99%

The development of an evidence-based patient booklet for patients undergoing lumbar discectomy and un-instrumented decompression

et al. 2006

View full text Add to dashboard Cite

Post-operative management after lumbar surgery is inconsistent leading to uncertainty amongst surgeons and patients about post-operative restrictions, reactivation, and return to work. This study aimed to review the evidence on post-operative management, with a view to developing evidence-based messages for a patient booklet on post-operative management after lumbar discectomy or un-instrumented decompression. A systematic literature search produced a best-evidence synthesis of information and advice on post-operative restrictions, activation, rehabilitation, and expectations about outcomes. Evidence statements were extracted and developed into patient-centred messages for an educational booklet. The draft text was evaluated by peer and patient review. The literature review found little evidence for post-operative activity restrictions, and a strong case for an early active approach to postoperative management. The booklet was built around key messages derived from the literature review and aimed to reduce uncertainty, promote positive beliefs, encourage early reactivation, and provide practical advice on self-management. Feedback from the evaluations were favourable from both review groups, suggesting that this evidence-based approach to management is acceptable and it has clinical potential.

show abstract

Importance of the Back-Café Concept to Rehabilitation After Lumbar Spinal Fusion: A Randomized Clinical Study With a 2-Year Follow-Up

Cited by 97 publications

References 32 publications

Leg pain and psychological variables predict outcome 2–3 years after lumbar fusion surgery

Leg pain and psychological variables predict outcome 2–3 years after lumbar fusion surgery

Rest versus exercise as treatment for patients with low back pain and Modic changes. a randomized controlled clinical trial

The development of an evidence-based patient booklet for patients undergoing lumbar discectomy and un-instrumented decompression

Contact Info

Product

Resources

About