2012년 10월 17일 수요일

An Evaluation of a Postoperative Rehabilitation Program After Spinal Surgery and Its Impact on Outcome


Surgery
Spine 2012;37:E417–E422

Title
An Evaluation of a Postoperative Rehabilitation Program After Spinal Surgery and Its Impact on Outcome

Authors
Alison H. McGregor
Ania Henley
Tim P. Morris
Caroline J. Doré

Study Design.

Multicenter, factorial, randomized controlled trial of the postoperative management (rehabilitation program) of spinal surgery patients


Objective

1. Determine the acceptability and content of the rehabilitation program

2. Evaluate the patients’ views of the rehabilitation intervention in terms of acceptability and content


Summary of Background Data

1. Use of rehabilitation after spinal surgery is sporadic

2. Evidence for its benefit is mixed.

3. Few study on a randomized controlled trial conducted to determine whether functional outcome of spinal surgery could be improved by a postoperative rehabilitation program


Methods

1. Patients randomized to postoperative rehabilitation (6 weeks)

2. Completed an evaluation of content, style, and length using forced choice and open questions


Results

1. Poor compliance with rehabilitation
*41% of subjects failing to attend any classes
*16% attending less than half

2. Compliance with the evaluation: 100% (105 patients attending 1 or more classes)

3. Length, content, and approach to the classes were rated positively, and patients gave the class a median rating of 9 of 10, range 5 to 10, with 91% rating the classes as 7 or above.


Conclusion

1. Compliance with a postoperative rehabilitation program was disappointing.

2. But the program was assessed positively and of benefit by those who attended.

3. Issues were raised in relation to timing and location of classes.

4. There is an increasing desire to locate such interventions out of the hospital environment.


Key Points

1. Compliance with postoperative rehabilitation was poor.

2. Those that did attend the classes rated them highly.

3. Patients perceived the classes were of value.



"This comes from Spine (c) 2012 Lippincott Williams & Wilkins, Inc."