TY - JOUR
T1 - Early postoperative physical activity and function
T2 - a descriptive case series study of 53 patients after lumbar spine surgery
AU - Coronado, Rogelio A.
AU - Master, Hiral
AU - White, Daniel K.
AU - Pennings, Jacquelyn S.
AU - Bird, Mackenzie L.
AU - Devin, Clinton J.
AU - Buchowski, Maciej S.
AU - Mathis, Shannon L.
AU - McGirt, Matthew J.
AU - Cheng, Joseph S.
AU - Aaronson, Oran S.
AU - Wegener, Stephen T.
AU - Archer, Kristin R.
N1 - Funding Information:
Dr. Coronado was supported by a Vanderbilt Faculty Research Scholars award during the time of manuscript preparation.
Funding Information:
This study was supported by a National Institutes of Health/National Institute of Arthritis and Musculoskeletal and Skin Diseases grant (R21 AR062880), Foundation for Physical Therapy Magistro Family research grant, and a Clinical and Translational Science Award from the National Center for Advancing Translational Sciences (UL1TR000445). The sponsors did not have any role in the study design, data collection or analyses, interpretation of data, manuscript preparation, or decision to publish the manuscript.
PY - 2020/12
Y1 - 2020/12
N2 - Background: The purpose of this prospective case series study was to compare changes in early postoperative physical activity and physical function between 6 weeks and 3 and 6 months after lumbar spine surgery. Methods: Fifty-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 6 weeks 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 (10 MW). 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 150 min/week in MVPA) and achieved clinically meaningful changes in physical function were compared at 3 and 6 months. Results: After surgery, 72% of patients initiated physical therapy (mean [95%CI] sessions =8.5 [6.6, 10.4]) between 6 weeks and 3 months. Compared to 6 weeks post-surgery, no change in steps/day or time in MVPA/week was observed at 3 or 6 months. From 21 to 23% and 9 to 11% of participants walked at least 4400 and 6000 steps/day at 3 and 6 months, respectively, while none of the participants spent at least 150 min/week in MVPA at these same time points. Significant improvements were observed on ODI, SF-12, TUG and 10 MW (p < 0.05), with over 43 to 68% and 62 to 87% achieving clinically meaningful improvements on these measures at 3 and 6 months, respectively. Conclusion: Limited improvement was observed in objectively-measured physical activity from 6 weeks to 6 months after spine surgery, despite moderate to large function gains. Early postoperative physical therapy interventions targeting physical activity may be needed.
AB - Background: The purpose of this prospective case series study was to compare changes in early postoperative physical activity and physical function between 6 weeks and 3 and 6 months after lumbar spine surgery. Methods: Fifty-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 6 weeks 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 (10 MW). 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 150 min/week in MVPA) and achieved clinically meaningful changes in physical function were compared at 3 and 6 months. Results: After surgery, 72% of patients initiated physical therapy (mean [95%CI] sessions =8.5 [6.6, 10.4]) between 6 weeks and 3 months. Compared to 6 weeks post-surgery, no change in steps/day or time in MVPA/week was observed at 3 or 6 months. From 21 to 23% and 9 to 11% of participants walked at least 4400 and 6000 steps/day at 3 and 6 months, respectively, while none of the participants spent at least 150 min/week in MVPA at these same time points. Significant improvements were observed on ODI, SF-12, TUG and 10 MW (p < 0.05), with over 43 to 68% and 62 to 87% achieving clinically meaningful improvements on these measures at 3 and 6 months, respectively. Conclusion: Limited improvement was observed in objectively-measured physical activity from 6 weeks to 6 months after spine surgery, despite moderate to large function gains. Early postoperative physical therapy interventions targeting physical activity may be needed.
KW - Physical activity
KW - Postoperative period
KW - Spinal fusion
KW - Spinal stenosis
KW - Walking
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U2 - 10.1186/s12891-020-03816-y
DO - 10.1186/s12891-020-03816-y
M3 - Article
C2 - 33246446
AN - SCOPUS:85096659729
VL - 21
JO - BMC Musculoskeletal Disorders
JF - BMC Musculoskeletal Disorders
SN - 1471-2474
IS - 1
M1 - 783
ER -