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PREPARE: Pre-surgery physiotherapy for patients with degenerative lumbar spine disorder: a randomized controlled trial protocol.
- Source :
- BMC Musculoskeletal Disorders; 7/11/2016, Vol. 17, p1-8, 8p, 1 Diagram, 2 Charts
- Publication Year :
- 2016
-
Abstract
- <bold>Background: </bold>Current guidelines for the management of patients with specific low back pain pathology suggest non-surgical intervention as first-line treatment, but there is insufficient evidence to make recommendations of the content in the non-surgical intervention. Opinions regarding the dose of non-surgical intervention that should be trialled prior to decision making about surgery intervention vary. The aim of the present study is to investigate if physiotherapy administrated before surgery improves function, pain and health in patients with degenerative lumbar spine disorder scheduled for surgery. The patients are followed over two years. A secondary aim is to study what factors predict short and long term outcomes.<bold>Methods: </bold>This study is a single blinded, 2-arm, randomized controlled trial with follow-up after the completion of pre-surgery intervention as well as 3, 12 and 24 months post-surgery. The study will recruit men and women, 25 to 80 years of age, scheduled for surgery due to; disc herniation, spinal stenosis, spondylolisthesis or degenerative disc disease. A total of 202 patients will be randomly allocated to a pre-surgery physiotherapy intervention or a waiting list group for 9 weeks. The waiting-list group will receive standardized information about surgery, post-surgical rehabilitation and advice to stay active. The pre-surgery physiotherapy group will receive physiotherapy 2 times per week, consisting of a stratified classification treatment, based on assessment findings. One of the following treatments will be selected; a) Specific exercises and mobilization, b) Motor control exercises or c) Traction. The pre-surgery physiotherapy group will also be prescribed a tailor-made general supervised exercise program. The physiotherapist will use a behavioral approach aimed at reducing patient fear avoidance and increasing activity levels. They will also receive standardized information about surgery, post-surgical rehabilitation and advice to stay active. Primary outcome measure is Oswestry Disability Index. Secondary outcome measures are the visual analogue scale for back and leg pain, pain drawing, health related quality of life, Hospital anxiety and depression scale, Fear avoidance beliefs questionnaire, Self-efficacy scale and Work Ability Index.<bold>Discussion: </bold>The study findings will help improve the treatment of patients with degenerative lumbar spine disorder scheduled for surgery.<bold>Trial Registration: </bold>ClinicalTrials.gov reference: NCT02454400 (Trial registration date: August 31st 2015) and has been registered on ClinicalTrials.gov, identifier: NCT02454400 . [ABSTRACT FROM AUTHOR]
- Subjects :
- LUMBAR vertebrae diseases
TREATMENT of backaches
PHYSICAL therapy
HEALTH outcome assessment
MEDICAL decision making
DEGENERATION (Pathology)
THERAPEUTICS
ANXIETY diagnosis
DIAGNOSIS of mental depression
PAIN management
SPINE diseases
LUMBAR pain
COMPARATIVE studies
FUNCTIONAL assessment
LUMBAR vertebrae
RESEARCH methodology
MEDICAL cooperation
RESEARCH protocols
PHYSICAL therapists
PREOPERATIVE care
PSYCHOLOGICAL tests
QUALITY of life
QUESTIONNAIRES
RESEARCH
SPINAL fusion
EVALUATION research
PAIN measurement
RANDOMIZED controlled trials
TREATMENT effectiveness
BLIND experiment
PSYCHOLOGY
Subjects
Details
- Language :
- English
- ISSN :
- 14712474
- Volume :
- 17
- Database :
- Complementary Index
- Journal :
- BMC Musculoskeletal Disorders
- Publication Type :
- Academic Journal
- Accession number :
- 116873680
- Full Text :
- https://doi.org/10.1186/s12891-016-1126-4