Quality of life and disability: can they be improved by active postoperative rehabilitation after spinal fusion surgery in patients with spondylolisthesis? A randomised controlled trial with 12-month follow-up

Ilves, Outi; Häkkinen, Arja; Dekker, Joost; Pekkanen, Liisa; Piitulainen, Kirsi; Järvenpää, Salme; Marttinen, Ilkka; Vihtonen, Kimmo; Neva, Marko H.

doi:10.1007/s00586-016-4789-5

Cited by 17 publications

(18 citation statements)

References 24 publications

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“…However, some other investigators may have a different viewpoint, even contrary to those positive ones. ey reported that postoperative rehabilitation management did not work as it should be, showing that the functional outcome, the disability, and patient life quality were not improved, even in a long-term observation [1,20,21]. Although the previous studies have drawn contradictory conclusions, our current study results are supporting the positive point of view that the postoperative rehabilitation is effective to promote health recovery and decrease the complications after spinal surgeries.…”

Section: Discussionsupporting

confidence: 67%

Clinical Rehabilitation Effect of Postoperative Lower-Limb Training on the Patients Undergoing OLIF Surgery: A Retrospective Study

Wang

Huo

Zhao

et al. 2020

Pain Research and Management

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Background. In this study, it was aimed to investigate the clinical rehabilitation effect of lower-limb training on the patients that undergo oblique lumbar interbody fusion (OLIF) procedures. Methods. The eligible participants undergoing OLIF procedures between 01/2017 and 07/2019 were identified. All the patients underwent one-segment fusion operation (L3-4 or L4-5). Based on whether the participants received postoperative rehabilitation training, they were divided into two groups: intervention group and control group. Postoperatively, the participants in the intervention group were trained with lower-extremity rehabilitation exercise and maintained for three months. All participants got reexamined at the first postoperative week, the second postoperative week, the first postoperative month, and the third postoperative month (last follow-up). Comparisons were made in terms of the lower-extremity muscle force, visual analogue scale (VAS) score, lumbar JOA score, Oswestry disability index (ODI), the incidence of deep venous thrombosis (DVT), and patient satisfaction. Results. Seventy-seven participants in the intervention group (32 males and 45 females) and 82 in the control group (39 males and 43 females) were incorporated in this study. The median age of the participants was 57 years (39∼73) in the intervention group and 54 years (35∼71) in the control group. No statistical significance between the two groups was found (P>0.05). ODI score was less in the intervention group as compared to the control group in the first week after surgery (P=0.029). VAS and JOA scores were better in the intervention group in the first two weeks after surgery (P<0.05). DVT incidence in the intervention group was lower than the control group at final follow-up (P=0.037). Both group participants have achieved good grading in muscle force rehabilitation but no significant differences between the two groups. Additionally, satisfaction was higher in the intervention group than the control group. Conclusions. In summary, postoperative lower-extremity rehabilitation exercise can effectively accelerate patients’ health recovery from the OLIF surgery and increase their satisfaction.

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Section: Discussionsupporting

confidence: 67%

Clinical Rehabilitation Effect of Postoperative Lower-Limb Training on the Patients Undergoing OLIF Surgery: A Retrospective Study

Wang

Huo

Zhao

et al. 2020

Pain Research and Management

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“…It is plausible that enhanced self-efficacy may be a group-mediated effect, which Bandura described as the collective efficacy of group interventions [24]. A recent similar study in which rehabilitation was delivered individually as opposed to a group setting demonstrated no significant between-group differences [25]. This finding potentially reinforces the critical relevance of the group effect.…”

Section: Discussionmentioning

confidence: 90%

Rehabilitation following lumbar fusion surgery (REFS) a randomised controlled feasibility study

et al. 2019

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Purpose Following lumbar fusion surgery (LFS), 40% of patients are unsure/dissatisfied with their outcome. A prospective, single-centre, randomised, controlled trial was conducted to evaluate the feasibility (including clinical and economic impact) of a theoretically informed rehabilitation programme following LFS (REFS). Methods REFS was informed by an explicit theoretical framework and consisted of 10 consecutive weekly group rehabilitation sessions (education, low-tech cardiovascular, limb and spine strengthening exercises, and peer support). Participants were randomised to REFS or 'usual care.' Primary feasibility outcomes included recruitment and engagement. Secondary outcomes, collected preoperatively and 3, 6, and 12 months postoperatively, comprised the Oswestry disability index, European Quality of Life 5 dimensions score, pain self-efficacy questionnaire, hospital anxiety and depression scale and the aggregated functional performance time. Economic impact was evaluated with the Client Services Receipt Inventory. Results Fifty-two of 58 eligible participants were recruited, and engagement with REFS was > 95%. REFS participants achieved a clinically meaningful reduction in unadjusted mean short-term disability (− 13.27 ± 13.46), which was not observed in the 'usual care' group (− 2.42 ± 12.33). This was maintained in the longer term (− 14.72% ± 13.34 vs − 7.57 ± 13.91). Multilevel regression analyses, adjusted for body mass index, baseline depression, and smoking status reported a statistically significant short-term improvement in disability (p = 0.014) and pain self-efficacy (p = 0.007). REFS costs £275 per participant.Conclusions Results suggest that REFS is feasible and potentially affordable for delivery in the National Health Service. It is associated with a clinically meaningful impact. A multicentre randomised controlled study to further elucidate these results is warranted. Graphical abstractThese slides can be retrieved under Electronic Supplementary Material. Key points 1. Rehabilitation 2. Lumbar fusion surgery 3. Theoretcial modelling Greenwood J, McGregor A, Jones F, Hurley M (2019) Rehabilitation following lumbar fusion surgery (REFS) a randomised controlled feasibility study. Eur Spine J; Greenwood J, McGregor A, Jones F, Hurley M (2019) Rehabilitation following lumbar fusion surgery (REFS) a randomised controlled feasibility study. Eur Spine J; Take Home Messages 1. Lumbar fusion surgery is associated with high levels of postoperative patient dissatisfaction.2. We describe a theoretically informed rehabilitation program, which appears feasible for delivery following lumbar fusion surgery (REFS).3. REFS participants appeared to have a short and longer term clinically meaningful improvement in disability and pain selfefficacy when compared to 'usual care'. Greenwood J, McGregor A, Jones F, Hurley M (2019) Rehabilitation following lumbar fusion surgery (REFS) a randomised controlled feasibility study. Eur Spine J;

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“…Neither rehabilitation program nor education booklet for the postoperative management had a significant impact on long-term outcome [ 12 ]. Recently, a randomized controlled trial [ 11 ] with 12-month follow-up indicated that quality of life and disability cannot be improved by active postoperative rehabilitation after spinal fusion surgery in patients with spondylolisthesis. However, the results from some other studies are to the contrary.…”

Section: Discussionmentioning

confidence: 99%

“…Postoperative rehabilitation has been reported to improve outcome after disc surgery [ 10 ]. However, some studies [ 1 , 2 , 11 ] reported that postoperative rehabilitation had no significant influence in pain and self-rated disability as compared to no treatment/self-management after lumbar surgery including lumbar disc herniation and spinal stenosis patients. Several randomized trials have found no significant difference between standard physical rehabilitation and either no treatment or an educational booklet [ 1 , 2 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

The effect of systematic lower-limb rehabilitation training in elderly patients undergoing lumbar fusion surgery: a retrospective study

et al. 2017

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ObjectivesThe purpose of this study was to explore the effect of systematic lower-limb rehabilitation training in elderly patients undergoing lumbar fusion surgery due to serious degenerative intervertebral disc diseases.ResultsAt the 1st week after surgery, clinical rehabilitation effect in intervention group was better regarding lower-limb muscle strength, lower-limb DVT, VAS score, and ODI, as compared with control group (all p < 0.05). During the first two weeks after surgery, satisfaction rate in intervention group was higher than that in control group. However, there was no significant difference at last follow-up after surgery when comparing intervention group to control group.Materials and MethodsWe retrospectively collected medical records of elderly patients (aged ≥ 60 yrs) undergoing lumbar fusion surgery between 01/2013 and 01/2015 in our department. Some of the identified patients randomly underwent postoperative systematic training of lower-limb rehabilitation gymnastics (intervention group, n = 240), the others not (control group, n = 300). During postoperative period, intervention group received lower-limb rehabilitation gymnastics treatment for 3 months, but control group did not. All patients were routinely asked to return hospital for a check in the 1st postoperative week, as well as the 2nd week, the 1st month, and the 3rd month. Clinical outcomes were evaluated by scoring lower-limb muscle strength, detecting lower-limb deep venous thrombosis (DVT), visual analogue scale (VAS) score, lumbar JOA score, Oswestry disability index (ODI) questionnaire, and performing satisfaction survey.ConclusionsIn early postoperative stage, systematic lower-limb rehabilitation training can effectively speed up the recovery, beneficial to reducing lower-limb DVT and increasing patient satisfaction rate.

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Quality of life and disability: can they be improved by active postoperative rehabilitation after spinal fusion surgery in patients with spondylolisthesis? A randomised controlled trial with 12-month follow-up

Cited by 17 publications

References 24 publications

Clinical Rehabilitation Effect of Postoperative Lower-Limb Training on the Patients Undergoing OLIF Surgery: A Retrospective Study

Clinical Rehabilitation Effect of Postoperative Lower-Limb Training on the Patients Undergoing OLIF Surgery: A Retrospective Study

Rehabilitation following lumbar fusion surgery (REFS) a randomised controlled feasibility study

The effect of systematic lower-limb rehabilitation training in elderly patients undergoing lumbar fusion surgery: a retrospective study

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