Patients with severe low back pain exhibit a low level of physical activity before lumbar fusion surgery: a cross-sectional study

Abstract

BackgroundPeople with severe low back pain are at higher risk of poor health. Patients scheduled for lumbar fusion surgery are assumed to have low levels of physical activity, but few data exist. The aim of the study was firstly to investigate preoperative levels of objectively measured physical activity in patients with severe low back pain waiting for lumbar fusion surgery, and secondly to investigate whether factors in the fear-avoidance model were associated with these levels.MethodsWe included 118 patients waiting for lumbar fusion surgery (63 women and 55 men; mean age 46 years). Physical activity expressed as steps per day and total time spent in at least moderate-intensity physical activity was assessed with ActiGraph GT3X+ accelerometers. The data were compared to the WHO recommendations on physical activity for health. Whether factors in the fear-avoidance model were associated with physical activity was evaluated by two different multiple linear regression models.ResultsNinety-six patients (83%) did not reach the WHO recommendations on physical activity for health, and 19 (16%) patients took fewer than 5000 steps per day, which indicates a sedentary lifestyle. On a group level, higher scores for fear of movement and disability were associated with lower numbers of steps per day.ConclusionA high proportion of the patients did not reach the WHO recommendations on physical activity and are therefore at risk of poor health due to insufficient physical activity. We also found a negative association between both fear of movement and disability, and the number of steps per day. Action needs to be taken to motivate patients to be more physically active before surgery, to improve health postoperatively. There is a need for interventions aimed at increasing physical activity levels and reducing barriers to physical activity in the prehabilitation phase of this patient group.Trial registrationCurrent Controlled Trials ISCRTN 17115599, retrospectively Registered 18 may 2015.

The effect of graded activity and pain education (GAPE): an early post-surgical rehabilitation programme after lumbar spinal fusion—study protocol for a randomized controlled trial

“…Low physical activity is a global health problem and may add a greater risk for a poor surgical outcome for patients undergoing LSF [ 5 ]. A cross-sectional study found that 83% of patients scheduled for LSF did not adhere to the World Health Organization recommendations regarding physical activity, i.e.…”

“…A cross-sectional study found that 83% of patients scheduled for LSF did not adhere to the World Health Organization recommendations regarding physical activity, i.e. 30 min per day [ 5 ]. Further, this seems to be unchanged 6 months after LSF [ 6 ], indicating that these patients may be at risk of poor health and lifestyle diseases due to insufficient physical activity [ 7 ].…”

“…There is growing evidence to suggest that, to increase physical activity and function in this group of patients, post-surgical rehabilitation should start early, and the content of the rehabilitation should be based on a bio-psycho-social approach [ 5 , 15 – 17 ]. A systematic review by Greenwood et al found that “complex interventions”, consisting of exercise and cognitive behavioural therapy, offer short-term and long-term functional benefits for patients following LSF [ 18 ].…”

The Efficiency And Safety Of Dexamethasone For Pain Relief Followed Lumbar Decompression And Fusion: A Systematic Review And Meta-Analysis

“…Lumbar degenerative disease (LDD) of the spine including disc herniation, spinal stenosis and other degenerative disc disease is fairly common among the people and also causes the considerable discomfort and dissatisfaction [1,2]. Most people of LDD are suffering from the low back pain (LBP) as an extremely common problem at some point in their life [3].…”

The effect of graded activity and pain education (GAPE) - an early post-surgical rehabilitation programme after lumbar spinal fusion: study protocol for a randomized controlled trial

“…There is growing evidence to suggest that, to increase physical activity and function in this group of patients, post-surgical rehabilitation should start early, and the content of the rehabilitation should be based on a bio-psycho-social approach (5,(15)(16)(17). A systematic review by Greenwood et al found that "complex interventions", consisting of exercise and cognitive behavioural therapy, offer short-term and long-term functional bene ts for patients following LSF (18).…”