Abstract
BackgroundPhysiotherapists are commonly involved in the management of patients immediately following lumbar spinal surgery. There is however, very little research to guide physiotherapy intervention in the acute post-operative period, and the advice provided to patients regarding post-operative walking and physical activity has been shown to be highly variable.The primary aim of this research is to establish whether the amount of walking patients perform in the week following lumbar spinal surgery predicts improvement in function at 6 months.MethodsThis study will be a prospective cohort study design, with a projected sample size of 250 participants. Patients undergoing surgery for the management of a disc prolapse, degenerative disc disease, lumbar spinal stenosis and/or degenerative spondylolysthesis will be invited to participate in this study.Outcome measurement will take place pre-operatively and at six months post-operatively. The primary outcome variable will be self-reported function, measured using the Modified Oswestry Disability Questionnaire and the physical component summary of the SF-36.Each participant will be fitted with an activPAL3 accelerometer to be worn for the first seven post-operative days. This accelerometer will record time spent in active versus sedentary postures, step count and time spent walking. Multivariable logistic regression analysis will be used to investigate the relationship between the total time spent walking over the first seven post-operative days, and outcome at six months.DiscussionThe results from this research will help to guide patient management during the inpatient phase, by identifying patients who are at risk of poorer outcome due to limited walking time. These patients may benefit from ongoing rehabilitation and outpatient physiotherapy services. This information will also provide a foundation for further research into interventions designed to optimise post-operative activity.Trial registration ACTRN12616000747426, retrospectively registered 7th June 2016.
Highlights
Physiotherapists are commonly involved in the management of patients immediately following lumbar spinal surgery
There is very little research to guide physiotherapy intervention in the acute post-operative period [10, 11], with considerable variability in the advice provided to patients regarding post-operative walking and general activity [7,8,9, 12]
The findings from this research will assist physiotherapists to identify patients who are expected to have either very good or poor post-operative outcomes based on their activity levels immediately following surgery, and inform physiotherapists about whether increasing activity should be a focus of post-operative rehabilitation
Summary
Physiotherapists are commonly involved in the management of patients immediately following lumbar spinal surgery. There is very little research to guide physiotherapy intervention in the acute post-operative period, and the advice provided to patients regarding post-operative walking and physical activity has been shown to be highly variable. The primary aim of this research is to establish whether the amount of walking patients perform in the week following lumbar spinal surgery predicts improvement in function at 6 months. The goals of physiotherapy intervention during the inpatient admission consistently focus on achieving independence. There is very little research to guide physiotherapy intervention in the acute post-operative period [10, 11], with considerable variability in the advice provided to patients regarding post-operative walking and general activity [7,8,9, 12]
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