Early postoperative physical activity and function: a descriptive case series study of 53 patients after lumbar spine surgery

被引：17

作者：

Coronado, Rogelio A. ^{[1
,2
]}

Master, Hiral ^{[1
]}

White, Daniel K. ^{[3
]}

Pennings, Jacquelyn S. ^{[1
]}

Bird, Mackenzie L. ^{[1
]}

Devin, Clinton J. ^{[1
,4
]}

Buchowski, Maciej S. ^{[5
]}

Mathis, Shannon L. ^{[6
]}

McGirt, Matthew J. ^{[7
]}

Cheng, Joseph S. ^{[8
]}

Aaronson, Oran S. ^{[9
]}

Wegener, Stephen T. ^{[10
]}

Archer, Kristin R. ^{[1
,2
]}

机构：

[1] Vanderbilt Univ, Dept Orthopaed Surg, Ctr Musculoskeletal Res, Med Ctr, 1215 21st Ave South,Med Ctr East South Tower, Nashville, TN 37232 USA

[2] Vanderbilt Univ, Dept Phys Med & Rehabil, Osher Ctr Integrat Med, Med Ctr, Nashville, TN 37232 USA

[3] Univ Delaware, Dept Phys Therapy, Newark, DE USA

[4] Steamboat Orthopaed & Spine Inst, Steamboat Springs, CO USA

[5] Vanderbilt Univ, Div Gastroenterol Hepatol & Nutr, Med Ctr, Nashville, TN USA

[6] Univ Alabama Huntsville, Dept Kinesiol, Huntsville, AL USA

[7] Carolina Neurosurg & Spine Associates, Dept Neurol Surg, Charlotte, NC USA

[8] Univ Cincinnati, Coll Med, Dept Neurol Surg, Cincinnati, OH USA

[9] St Thomas Med Partners, Howell Allen Clin, Nashville, TN USA

[10] Johns Hopkins Univ, Dept Phys Med & Rehabil, Baltimore, MD USA

来源：

BMC MUSCULOSKELETAL DISORDERS | 2020年 / 21卷 / 01期

基金：

美国国家卫生研究院;

关键词：

Walking; Physical activity; Postoperative period; Spinal stenosis; Spinal fusion; QUALITY-OF-LIFE; LOW-BACK-PAIN; OLDER-ADULTS; TOTAL HIP; KNEE OSTEOARTHRITIS; FUSION SURGERY; MIDDLE-AGE; STENOSIS; TRENDS; TIME;

D O I：

10.1186/s12891-020-03816-y

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

BackgroundThe purpose of this prospective case series study was to compare changes in early postoperative physical activity and physical function between 6weeks and 3 and 6months after lumbar spine surgery.MethodsFifty-three patients (mean [95% confidence interval; CI] age=59.2 [56.2, 62.3] years, 64% female) who underwent spine surgery for a degenerative lumbar condition were assessed at 6weeks and 3- and 6-months after surgery. The outcomes were objectively-measured physical activity (accelerometry) and patient-reported and objective physical function. Physical activity was assessed using mean steps/day and time spent in moderate to vigorous physical activity (MVPA) over a week. Physical function measures included Oswestry Disability Index (ODI), 12-item Short Form Health Survey (SF-12), Timed Up and Go (TUG), and 10-Meter Walk (10MW). We compared changes over time in physical activity and function using generalized estimating equations with robust estimator and first-order autoregressive covariance structure. Proportion of patients who engaged in meaningful physical activity (e.g., walked at least 4400 and 6000 steps/day or engaged in at least 150min/week in MVPA) and achieved clinically meaningful changes in physical function were compared at 3 and 6months.ResultsAfter surgery, 72% of patients initiated physical therapy (mean [95%CI] sessions =8.5 [6.6, 10.4]) between 6weeks and 3months. Compared to 6weeks post-surgery, no change in steps/day or time in MVPA/week was observed at 3 or 6months. From 21 to 23% and 9 to 11% of participants walked at least 4400 and 6000 steps/day at 3 and 6months, respectively, while none of the participants spent at least 150min/week in MVPA at these same time points. Significant improvements were observed on ODI, SF-12, TUG and 10MW (p< 0.05), with over 43 to 68% and 62 to 87% achieving clinically meaningful improvements on these measures at 3 and 6months, respectively.ConclusionLimited improvement was observed in objectively-measured physical activity from 6weeks to 6months after spine surgery, despite moderate to large function gains. Early postoperative physical therapy interventions targeting physical activity may be needed.

引用

页数：10

共 73 条

[1] Surgical outcome of 438 patients treated surgically for lumbar spinal stenosis [J].