Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2016

Open Access 01-12-2016 | Study protocol

Does walking after lumbar spinal surgery predict recovery of function at six months? Protocol for a prospective cohort study

Authors: Sarah Gilmore, Jodie A. McClelland, Megan Davidson

Published in: BMC Musculoskeletal Disorders | Issue 1/2016

Login to get access

Abstract

Background

Physiotherapists 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.

Methods

This 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.

Discussion

The 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

ACTRN12616000747​426, retrospectively registered 7th June 2016.
Literature
1.
Hoy D, March L, Brooks P, Blyth F, Woolf A, Bain C, Williams G, Smith E, Vos T, Barendregt J, Murray C, Burstein R, Buchbinder R. The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis. 2014;73:968–74.CrossRefPubMed
2.
Koes BW, van Tulder M, Lin CC, Macedo LG, McAuley J, Maher C. An updated overview of clinical guidelines for the management of non-specific low back pain in primary care. Eur Spine J. 2010;19:2075–94.CrossRefPubMedPubMedCentral
3.
Jacobs WCH, van Tulder M, Arts M, Rubinstein SM, van Middelkoop M, Ostelo R, Verhagen A, Koes B, Peul WC. Surgery versus conservative management of sciatica due to a lumbar herniated disc: a systematic review. Eur Spine J. 2011;20:513–22.CrossRefPubMed
4.
Phillips FM, Slosar PJ, Youssef JA, Andersson G, Papatheofanis F. Lumbar spine fusion for chronic low back pain due to degenerative disc disease: a systematic review. Spine. 2013;38:E409–22.CrossRefPubMed
5.
Kovacs FM, Urrútia G, Alarcón JD. Surgery versus conservative treatment for symptomatic lumbar spinal stenosis: a systematic review of randomized controlled trials. Spine. 2011;36:E1335–51.CrossRefPubMed
6.
Weinstein JN, Tosteson TD, Lurie JD, Tosteson A, Blood E, Herkowitz H, Cammisa F, Albert T, Boden SD, Hilibrand A, Goldberg H, Berven S, An H. Surgical versus non-operative treatment for lumbar spinal stenosis four year results of the Spine Patient Outcomes Research Trial (SPORT). Spine. 2010;35:1329–38.CrossRefPubMedPubMedCentral
7.
Gilmore SJ, McClelland JA, Davidson M. Physiotherapy management of patients undergoing lumbar spinal surgery for degenerative conditions: a survey of Australian physiotherapists. NZJ Physiother. 2016;44:105–12.
8.
Rushton A, Heneghan N, Heap A, White L, Eveleigh G, Wright C. Survey of current physiotherapy practice for patients undergoing lumbar spinal fusion in the UK. Spine. 2014;39:E1380–7.CrossRefPubMed
9.
Williamson E, White L, Rushton A. A survey of post-operative management for patients following first time lumbar discectomy. Eur Spine J. 2007;16:795–802.CrossRefPubMed
10.
Gilmore SJ, McClelland JA, Davidson M. Physiotherapeutic interventions before and after surgery for degenerative lumbar conditions: a systematic review. Physiotherapy. 2015;101:111–8.CrossRefPubMed
11.
12.
13.
Glassman SD, Polly DW, Bono CM, Burkus K, Dimar JR. Outcome of lumbar arthrodesis in patients sixty-five years of age or older. J Bone Joint Surg Am. 2009;91:783–90.CrossRefPubMed
14.
Pearson A, Lurie J, Tosteson T, Zhao W, Abdu W, Weinstein J. Who should have surgery for spinal stenosis?: Treatment effect predictors in SPORT. Spine. 2012;37:1791–802.CrossRefPubMedPubMedCentral
15.
Sandén B, Försth P, Michaëlsson K. Smokers show less improvement than nonsmokers two years after surgery for lumbar spinal stenosis: a study of 4555 patients from the Swedish spine register. Spine. 2011;36:1059–64.CrossRefPubMed
16.
Appaduray SP, Lo P. Effects of diabetes and smoking on lumbar spinal surgery outcomes. J Clin Neurosci. 2013;20:1713–7.CrossRefPubMed
17.
Guzman JZ, Iatridis JC, Skovrlj B, Cutler H, Hecht AC, Qureshi SA, Cho SK. Outcomes and complications of diabetes mellitus on patients undergoing degenerative lumbar spine surgery. Spine. 2014;39:1596–604.CrossRefPubMedPubMedCentral
18.
Jiang J, Teng Y, Fan Z, Khan S, Xia Y. Does obesity affect the surgical outcome and complication rates of spinal surgery? A meta-analysis. Clin Orthop Relat Res. 2014;472:968–75.CrossRefPubMed
19.
Miller JA, Derakhshan A, Lubelski D, Alvin MD, McGirt MJ, Benzel EC, Mroz TE. The impact of preoperative depression on quality of life outcomes after lumbar surgery. Spine J. 2015;15:58–64.CrossRefPubMed
20.
Sinikallio SA, Timo A, Olavi L, Soili M, Kröger H, Viinamäki H. Depression is associated with a poorer outcome of lumbar spinal stenosis surgery: a two-year prospective follow-up study. Spine. 2011;36:677–82.CrossRefPubMed
21.
Archer KR, Seebach CL, Mathis SL, Riley Iii LH, Wegener ST. Early postoperative fear of movement predicts pain, disability, and physical health six months after spinal surgery for degenerative conditions. Spine J. 2014;14(5):759–67.CrossRefPubMed
22.
23.
Kalisch BJ, Lee S, Dabney BW. Outcomes of inpatient mobilization: a literature review. J Clin Nurs. 2013;23:1486–501.CrossRefPubMed
24.
Berendsen B, Hendriks M, Meijer K, Plasqui G, Schaper N, Savelberg H. Which activity monitor to use? Validity, reproducibility and user friendliness of three activity monitors. BMC Public Health. 2014;14:749.CrossRefPubMedPubMedCentral
25.
Dahlgren G, Carlsson D, Moorhead A, Hager-Ross C, McDonough SM. Test-retest reliability of step counts with the ActivPAL device in common daily activities. Gait Posture. 2010;32:386–90.CrossRefPubMed
26.
Grant PM, Ryan CG, Tigbe WW, Granat MH. The validation of a novel activity monitor in the measurement of posture and motion during everyday activities. Br J Sports Med. 2006;40:992–7.CrossRefPubMedPubMedCentral
27.
Mobbs RJ, Phan K, Maharaj M, Rao PJ. Physical activity measured with accelerometer and self-rated disability in lumbar spine surgery: a prospective study. Glob Spine J. 2016;6:459–64.CrossRef
28.
Schulte TL, Schubert T, Winter C, Brandes M, Hackenburg L, Wassmann H, Liem D, Rosenbaum D, Bullmann V. Step activity monitoring in lumbar stenosis patients undergoing decompressive surgery. Eur Spine J. 2010;19:1855–64.CrossRefPubMedPubMedCentral
29.
Vittinghoff E, McCulloch CE. Relaxing the rule of ten events per variable in logistic and cox regression. Am J Epidemiol. 2007;165:710–8.CrossRefPubMed
30.
Davidson M, Keating JL. A comparison of five low back disability questionnaires: reliability and responsiveness. Phys Ther. 2002;82:8–24.CrossRefPubMed
31.
Ware JE, Kosinski MA, Bjorner JB, Turner-Bowker DM, Gandeck B, Maruish ME. User’s manual for the SF-36 Health Survey (Version 2). 2nd ed. 2007.
32.
Ware JE, Sherbourne CD. The MOS 36-ltem Short-Form Health Survey (SF-36): I. Conceptual framework and item selection. Med Care. 1992;30:473–83.CrossRefPubMed
33.
Jensen MP, Turner JA, Romano JM. What is the maximum number of levels needed in pain intensity measurement? Pain. 1994;58:387–92.CrossRefPubMed
34.
Chapman JR, Norvell DC, Hermsmeyer JT, Bransford RJ, DeVine J, McGirt MJ, Lee MJ. Evaluating common outcomes for measuring treatment success for chronic low back pain. Spine. 2011;36:S54–68.CrossRefPubMed
35.
Rihn JA, Hilibrand AS, Radcliff K, Kurd M, Lurie J, Blood E, Albert TJ, Weinstein JN. Duration of symptoms resulting from lumbar disc herniation: effect on treatment outcomes: analysis of the Spine Patient Outcomes Research Trial (SPORT). J Bone Joint Surg Am. 2011;93:1906–14.CrossRefPubMed
36.
37.
Choi Y, Mayer TG, Williams MJ, Gatchel RJ. What is the best screening test for depression in chronic spinal pain patients? Spine J. 2014;14:1175–82.CrossRefPubMed
38.
Spitzer RL, Kroenke K, Williams JB, Lowe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166:1092–7.CrossRefPubMed
39.
Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, Oja P. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35:1381–95.CrossRefPubMed
40.
Helmerhorst HJ, Brage S, Warren J, Besson H, Ekelund U. A systematic review of reliability and objective criterion-related validity of physical activity questionnaires. Int J Behav Nutr Phys Act. 2012;9:103.CrossRefPubMedPubMedCentral
41.
Ostelo RWJG, Deyo RA, Stratford P, Waddell G, Croft P, Von Korff M, Bouter LM, de Vet HC. Interpreting change scores for pain and functional status in low back pain: towards international consensus regarding minimal important change. Spine. 2008;33:90–4.CrossRefPubMed
42.
Glassman SD, Copay AG, Berven SH, Polly DW, Subach BR, Carreon LY. Defining substantial clinical benefit following lumbar spine arthrodesis. J Bone Joint Surg Am. 2008;90:1839–47.CrossRefPubMed
43.
Katz M. Multivariable analysis a practical guide for clinicians and public health researchers. 3rd ed. Cambridge: Cambridge University Press; 2011.CrossRef
Metadata
Title
Does walking after lumbar spinal surgery predict recovery of function at six months? Protocol for a prospective cohort study
Authors
Sarah Gilmore
Jodie A. McClelland
Megan Davidson
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2016
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-016-1296-0

Other articles of this Issue 1/2016

BMC Musculoskeletal Disorders 1/2016 Go to the issue

Research article

Few geographic and socioeconomic variations exist in primary total shoulder arthroplasty: a multi-level study of Australian registry data

Research article

A new adjustable parallel drill guide for internal fixation of femoral neck fracture: a developmental and experimental study

Research article

Eye movements in patients with Whiplash Associated Disorders: a systematic review

Case report

Bilateral patellar tendon reconstruction using LARS ligaments: case report and review of the literature

Study protocol

Integrating Mobile health and Physical Activity to reduce the burden of Chronic low back pain Trial (IMPACT): a pilot trial protocol

Research article

Lethal multiple pterygium syndrome, the extreme end of the RYR1 spectrum