Preoperative spinal education for lumbar spinal stenosis: A feasibility study.

Autor: Eubanks JE; Department of Orthopaedics and Physical Medicine, Division of Physical Medicine and Rehabilitation, Medical University of South Carolina (MUSC), Charleston, South Carolina, USA.; Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center (UPMC), Pittsburgh, Pennsylvania, USA., Cupler ZA; Physical Medicine & Rehabilitative Services, Butler VA Health Care System, Butler, Pennsylvania, USA.; Institute for Clinical Research Education, University of Pittsburgh, Pittsburgh, Pennsylvania, USA., Gliedt JA; Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA., Bejarano G; Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island, USA., Skolasky RL; Orthopaedic Surgery and Physical Medicine & Rehabilitation, Surgical Outcomes Research Center, Johns Hopkins University, Baltimore, Maryland, USA., Smeets RJEM; Pain in Motion International Research Group (PiM), Research School CAPHRI, Department of Rehabilitation Medicine, Maastricht University and CIR Revalidatie, Eindhoven, The Netherlands., Schneider MJ; Department of Physical Therapy, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Jazyk: angličtina
Zdroj: PM & R : the journal of injury, function, and rehabilitation [PM R] 2024 Sep; Vol. 16 (9), pp. 992-1000. Date of Electronic Publication: 2024 Apr 05.
DOI: 10.1002/pmrj.13140
Abstrakt: Introduction: Lumbar spinal stenosis (LSS) is a leading cause of chronic musculoskeletal pain among older adults. A common and costly intervention for the treatment of LSS is lumbar decompression with or without fusion (LSS surgery), which has mixed outcomes among patients. Prehabilitation is a strategy designed to optimize the consistency of positive surgical outcomes and promote patient self-efficacy, while attempting to mitigate postoperative complications. No efforts have investigated the prehabilitation strategies specifically for patients undergoing LSS surgery.
Objective: To determine the feasibility of delivery and acceptability by participants of a novel prehabilitation intervention for patients undergoing LSS surgery.
Design: Feasibility study.
Setting: Outpatient orthopedic clinic at an academic medical center.
Participants: Patients at least 50 years of age, who were scheduled for LSS surgery between October 2020 and October 2021.
Intervention: PreOperative Spinal Education for Lumbar Spinal Stenosis (POSE-LSS), is a novel multimodal, education-focused, time-efficient prehabilitation program for patients undergoing LSS surgery. Participants received the following: (1) Educational booklet and video; (2) In-person physical therapy (PT) session; and (3) Telemedicine visit with a physiatrist.
Main Outcome Measure(s): The primary outcomes of interest were feasibility and acceptability of intervention by participants. Key potential surgical outcomes were length of stay and discharge disposition.
Results: POSE-LSS was completed by all eligible participants enrolled (n = 15) indicating feasibility and acceptability. Potential effectiveness measures including length of stay and discharge disposition were positively associated with the POSE-LSS intervention.
Conclusions: This study demonstrates that a novel prehabilitation intervention is feasible, acceptable, and appears positively associated with important short-term measures of postoperative recovery that may impact the trajectory of patient care following LSS surgery.
(© 2024 American Academy of Physical Medicine and Rehabilitation.)
Databáze: MEDLINE
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