Healthy Physical Activity Levels Below Recommended Thresholds Two Years After Lumbar Spine Surgery

STUDY DESIGN Prospective analysis. OBJECTIVE To quantify physical activity after lumbar surgery and identify spine-related variables associated with not meeting recommended activity thresholds. SUMMARY OF BACKGROUND DATA National guidelines recommend ≥150 minutes/week of moderate-intensity activity; however, only 52% of the general population meets this threshold. For patients not participating in exercise/sports, ≥1400 kcal/week of energy expenditure, including from walking, is another threshold. Potential spine-related variables associated with not meeting these thresholds after lumbar surgery have not been described. METHODS Clinical data were collected pre- and intraoperatively for 422 patients. Patients were contacted 2.2 years postoperatively to measure several patient-reported outcomes, including physical activity with the Paffenbarger Physical Activity and Exercise Index. The Paffenbarger Physical Activity and Exercise Index encompasses blocks walked, stairs climbed, and exercise/sports. Minutes/week of activity and total kcal/week were calculated and compared to recommended thresholds. Spine-related variables associated with not meeting thresholds were assessed in multivariable analyses. RESULTS Mean age was 57 years, 55% were men, 80% had degenerative diagnoses, and 63% had multilevel surgery. Only 35% met ≥1400 kcal/week; in multivariable analysis, not meeting this threshold was associated with revision surgery (OR 0.53, CI 0.30-0.95), surgery at ≥3 levels (OR 0.51, CI 0.31-0.84), and more postoperative back pain (OR 0.38, CI 0.24-0.59) (P