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Crites S, Neto K, Lee M, Louie K, Boone S, Fitzpatrick B, Silva D, Carvalho do Nascimento P, Bakaa N, Macedo L. Experiences and perceptions of adults pre- and/or post-lumbar spine surgery: a meta-ethnography. Disabil Rehabil 2024; 46:2477-2495. [PMID: 37475154 DOI: 10.1080/09638288.2023.2233895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 07/04/2023] [Indexed: 07/22/2023]
Abstract
STUDY DESIGN Qualitative meta-ethnography. Pre-registered with OSF:10.17605/OSF.IO/UTZE6. PURPOSE To understand the patient experience pre- and/or post-lumbar spine surgery. METHODS Literature search: A literature search was conducted in MEDLINE, EMBASE, EmCare and CINAHL from inception to October 17, 2022. Study selection criteria: Peer-reviewed qualitative or mixed-method studies of English text investigating the beliefs, perceptions, or experiences of adults (≥18 years old) pre- and/or post-lumbar spine surgery for degenerative, non-traumatic or non-infectious concerns. Data synthesis: The eMERGE meta-ethnography reporting guidelines were followed to create themes and subthemes from the original themes of the included studies. A quality appraisal was performed using the McMaster Quality Appraisal tool. RESULTS We included 18 studies and identified five themes that were separated into pre- and post-operative categories. The two pre-operative themes included [1]: the influence of physiotherapy interventions on patients' experiences, and [2] the importance of education/the power of communication, and the three post-operative themes included [1]: psychosocial coping [2], redefining oneself post-operatively, and [3] experience with the healthcare system. CONCLUSIONS These findings emphasize the complexity of the peri-operative experience for individuals undergoing lumbar spine surgery. Future research should focus on addressing psychosocial factors that may optimize patient experiences and recovery following LSS.
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Affiliation(s)
- Stephanie Crites
- Faculty of Health Sciences, School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Kajal Neto
- Faculty of Health Sciences, School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Meaghan Lee
- Faculty of Health Sciences, School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Kristen Louie
- Faculty of Health Sciences, School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Stephanie Boone
- Faculty of Health Sciences, School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Barrett Fitzpatrick
- Faculty of Health Sciences, School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Diego Silva
- Faculty of Health Sciences, School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada
| | | | - Nora Bakaa
- Faculty of Health Sciences, School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Luciana Macedo
- Faculty of Health Sciences, School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada
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Sakaguchi T, Gunjotikar S, Tanaka M, Komatsubara T, Latka K, Ekade SJ, Prabhu SP, Takamatsu K, Yasuda Y, Nakagawa M. Evaluation and Rehabilitation after Adult Lumbar Spine Surgery. J Clin Med 2024; 13:2915. [PMID: 38792457 PMCID: PMC11122457 DOI: 10.3390/jcm13102915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/07/2024] [Accepted: 05/14/2024] [Indexed: 05/26/2024] Open
Abstract
Purpose: With an increase in the proportion of elderly patients, the global burden of spinal disease is on the rise. This is gradually expected to increase the number of surgical procedures all over the world in the near future. As we know, rehabilitation following spine surgery is critical for optimal recovery. However, the current literature lacks consensus regarding the appropriate post-operative rehabilitation protocol. The purpose of this review is to evaluate the optimal protocol for rehabilitation after lumbar spine surgery in adults. Materials and Methods: The goals of rehabilitation after lumbar spine surgery are to improve physical and psychosocial function and may include multiple modalities such as physical therapy, cognitive behavioral therapy, specialized instruments, and instructions to be followed during activities of daily living. In recent years, not only are a greater number of spine surgeries being performed, but various different techniques of lumbar spine surgery and spinal fusion have also emerged. (1) Our review summarizes post-operative rehabilitation under the following headings-1. Historical aspects, 2. Subjective functional outcomes, and (3) Actual rehabilitation measures, including balance. Results: Physical therapy programs need to be patient-specific and surgery-specific, such that they consider patient-reported outcome measures and take into consideration the technique of spinal fusion used and the muscle groups involved in these surgeries. By doing so, it is possible to assess the level of functional impairment and then specifically target the strengthening of those muscle groups affected by surgery whilst also improving impaired balance and allowing a return to daily activities. Conclusions: Rehabilitation is a multi-faceted journey to restore mobility, function, and quality of life. The current rehabilitation practice focuses on muscle strengthening, but the importance of spinal balance is less elaborated. We thus equally emphasize muscle strengthening and balance improvement post-lumbar spine surgery.
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Affiliation(s)
- Tomoyoshi Sakaguchi
- Department of Rehabilitation, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, Japan; (T.S.); (K.T.); (Y.Y.); (M.N.)
| | - Sharvari Gunjotikar
- Department of Orthopedic Surgery, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, Japan; (S.G.); (T.K.); (K.L.); (S.J.E.); (S.P.P.)
| | - Masato Tanaka
- Department of Orthopedic Surgery, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, Japan; (S.G.); (T.K.); (K.L.); (S.J.E.); (S.P.P.)
| | - Tadashi Komatsubara
- Department of Orthopedic Surgery, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, Japan; (S.G.); (T.K.); (K.L.); (S.J.E.); (S.P.P.)
| | - Kajetan Latka
- Department of Orthopedic Surgery, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, Japan; (S.G.); (T.K.); (K.L.); (S.J.E.); (S.P.P.)
| | - Shashank J. Ekade
- Department of Orthopedic Surgery, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, Japan; (S.G.); (T.K.); (K.L.); (S.J.E.); (S.P.P.)
| | - Shrinivas P. Prabhu
- Department of Orthopedic Surgery, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, Japan; (S.G.); (T.K.); (K.L.); (S.J.E.); (S.P.P.)
| | - Kazuhiko Takamatsu
- Department of Rehabilitation, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, Japan; (T.S.); (K.T.); (Y.Y.); (M.N.)
| | - Yosuke Yasuda
- Department of Rehabilitation, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, Japan; (T.S.); (K.T.); (Y.Y.); (M.N.)
| | - Masami Nakagawa
- Department of Rehabilitation, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, Japan; (T.S.); (K.T.); (Y.Y.); (M.N.)
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Tekmyster G, Jonely H, Lee DW, Myerson J, Avery M, Moradian M, Desai MJ. Physical Therapy Considerations and Recommendations for Patients Following Spinal Cord Stimulator Implant Surgery. Neuromodulation 2023; 26:260-269. [PMID: 33819381 DOI: 10.1111/ner.13391] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/01/2021] [Accepted: 03/08/2021] [Indexed: 01/11/2023]
Abstract
OBJECTIVES Spinal cord stimulation (SCS) is an established therapy option in interventional pain medicine. Recent advances in technology have allowed for greater compliance with treatment and improved efficacy in pain control. This article was proposed to fill the gap in the literature addressing this specific patient population and to facilitate further research. Even though there is a lack of consensus among societies and experts on exact parameters of physical therapy (PT) considerations and postoperative limitations in patients with SCS, we propose rehabilitative care for this population should be standardized. As the number of patients with SCS implants grow, it is vital to understand how to appropriately approach patients with implantable devices when additional treatments such as PT are prescribed. MATERIALS AND METHODS A literature search was performed on the use of PT following SCS implantation. Presently, there is no literature to date which addresses the use of PT in this patient population. The lack of data is the largest hurdle in the creation of formal SCS therapy guidelines. The authors therefore proposed recommendations for rehabilitation based upon a detailed understanding of SCS hardware alongside well-studied physiotherapy concepts. RESULTS Considerations when initiating PT in the SCS patient population should include: 1) biomechanics and quality of SCS output; 2) therapeutic exercise and spinal manipulation in association with risk for lead migration and fracture; 3) the application of therapeutic modalities and risk for injury to the patient and/or damage to the SCS componentry; and 4) integration of a biopsychosocial, person-centered approach. CONCLUSIONS PT treatment protocol in patients with a recently implanted SCS device should be person-centered addressing individual needs, values, and goals. Further research is needed to fully appreciate the impact of an interprofessional approach to management of SCS patients, particularly following stimulator implantation.
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Affiliation(s)
- Gene Tekmyster
- Keck Medicine of USC, Orthopaedic Surgery, Los Angeles, CA, USA
| | - Holly Jonely
- International Spine Pain & Performance Center, Washington, DC, USA
| | - David W Lee
- Fullerton Orthopedic Surgery Medical Group, Fullerton, CA, USA.
| | - Jason Myerson
- Performance Physical Therapy & Wellness, Westport, CT, USA
| | - Melinda Avery
- International Spine Pain & Performance Center, Washington, DC, USA
| | | | - Mehul J Desai
- International Spine Pain & Performance Center, Washington, DC, USA
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Postoperative Cognitive Behavioral Intervention in Patients with Coronary Heart Disease Based on the Effect of Nursing Process Reengineering. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6974909. [PMID: 36164450 PMCID: PMC9509227 DOI: 10.1155/2022/6974909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/16/2022] [Accepted: 09/02/2022] [Indexed: 11/18/2022]
Abstract
With the development of society and economy, patients with coronary heart disease increasingly hope to receive more humanized services after surgery, and the reengineering of the nursing process is precisely based on humanized management. In order to create a nursing intervention that helps in boosting total nursing gains and lowering disasters, the primary element of the nursing business process reengineering is to reintegrate or condense the creative work flow that was fragmented by specialization into a whole job. The “patient” is positioned in the center of nursing process reengineering, with service quality as the main guiding principle. It follows the management principles of continuous regulation and innovation, and cultivates and promotes the development of the nursing field from the perspective of “sublation.” In the method part, this article introduces and supplements related information on nursing process reengineering, coronary heart disease, and postoperative cognitive behavioral intervention. Algorithmically, this paper proposes 3D RPN structure, loss function, capsule network, and improved activation function algorithm for coronary heart disease region extraction. In the part of experiment and results, this article collects general data of patients and compares memory ability, grades of self-management behaviors of patients treated with coronary heart disease, scores of quality control standards before and after nursing process reengineering, scores of patients' mental state, and comparison of postoperative physical indicators. According to the test results, the test group's diastolic and systolic blood pressure declined by more than 20, their total cholesterol dropped from 6.23 to 5.28, and their triglyceride levels dropped from 1.82 to 1.39 after the stent was implanted. Triglycerides reduced from 1.82 to 1.39, and total cholesterol dropped from 6.15 to 5.98. It indicates postoperative memory in patients with coronary heart disease. Abilities, including recognition, number, touch memory, and associative memory, decline significantly, but it can be improved after receiving the nursing process reengineering. It can be seen that nursing process reengineering can play a positive role in the postoperative cognitive behavior of patients with coronary heart disease.
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Guo YJ, Hu XY, Li JY, Yang L. Effects of a WeChat-based individualized post-discharge rehabilitation program on patients with lumbar fusion surgery. J Back Musculoskelet Rehabil 2022; 35:545-557. [PMID: 34744066 DOI: 10.3233/bmr-200280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Exercise training after lumbar fusion surgery (LFS) is important for regaining the strength in the spinal muscles, pain management, and minimizing dysfunction. It may be prudent to evaluate technologies such as web-based chat and social media apps for increasing the efficacy of post-surgery interventions in LFS patients. OBJECTIVE To explore the effectiveness of a WeChat-based individualized post-discharge rehabilitation program in patients with LFS. METHODS Seventy-two eligible discharged LFS patients were enrolled from October 2018 to February 2019. The experimental group (36 cases) received a 10-week WeChat-based individualized rehabilitation program, while the control group (36 cases) received routine follow-up guidance. The outcomes were measured using the Exercise Compliance Questionnaire, Numerical Rating Scale, Oswestry Disability Index and Chinese version of the self-efficacy for exercise scale. RESULTS The analysis using generalized estimation equations method shows significant differences in the interaction effect of group*time in exercise compliance (Wald c2= 7.459, P< 0.05), group effect in pain (Wald c2= 5.811, P< 0.05) and self-efficacy (Wald c2= 16.383, P< 0.05). However, there was no significant difference between the experimental and control groups in the group effect in dysfunction improvement (Wald c2= 2.289, P> 0.05). CONCLUSIONS The WeChat-based rehabilitation intervention can improve exercise compliance and self-efficacy, and help achieve greater pain relief compared to the routine intervention. However, the WeChat-based intervention did not offer better improvement in the self-dysfunction in the post-discharge LFS patients.
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Affiliation(s)
- Yu-Jie Guo
- School of Medicine (School of Nursing), Nantong University, Nantong, Jiangsu, China
| | - Xiao-Yun Hu
- School of Pharmacy , Nanjing Medical University, Nanjing, Jiangsu, China.,School of Medicine (School of Nursing), Nantong University, Nantong, Jiangsu, China
| | - Jia-Yu Li
- School of Health and Nursing Science, Nantong Institute of Technology, Nantong, Jiangsu, China.,School of Medicine (School of Nursing), Nantong University, Nantong, Jiangsu, China
| | - Lei Yang
- First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
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Dupeyron A, Ribinik P, Rannou F, Kabani S, Demoulin C, Dufour X, Foltz V, Godard J, Huppert J, Nizard J, Petit A, Silvestre C, Kouyoumdjian P, Coudeyre E. Rehabilitation and lumbar surgery: the French recommendations for clinical practice. Ann Phys Rehabil Med 2021; 64:101548. [PMID: 34192564 DOI: 10.1016/j.rehab.2021.101548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 05/24/2021] [Accepted: 06/01/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Indications and techniques of rehabilitation differ widely across types of lumbar surgery, including timing (before or after surgery) and prescriptions (surgeons but also medical or paramedical professionals). OBJECTIVES This project aimed to build consensual recommendations for practice in this context. METHODS The SOFMER methodology was used to establish recommendations for physical medicine and rehabilitation: a steering committee defined the types of lumbar surgery involved and developed the main questions to be addressed; a scientific committee performed a literature review for grading evidence and proposed the first version of recommendations, which were discussed during a dedicated session at the national Physical and Rehabilitation Medicine congress; then an e-Delphi method with cross-professional experts was used to finalise recommendations and reach a multidisciplinary consensus. RESULTS The main questions developed were the value of rehabilitation before and after surgery, timing and type of rehabilitation, benefit of supervision and instrumental rehabilitation, value of patient education, and complementary interventions concerning rehabilitation for discectomy, fusion, and disc prosthesis (excluding decompression for spinal stenosis). The literature review identified 60 articles, but for several of the questions, no article in the literature addressed the issue. The multidisciplinary scientific committee analysed the literature and addressed the questions to propose the first version of a set of 23 recommendations. The congress session failed to answer all questions or to reach consensus for all items. After a three-step e-Delphi, 20 recommendations were retained, for which consensus among experts was reached. The recommendations are applicable only to patients without a neurological lesion. CONCLUSIONS These recommendations provide important and consensual knowledge to assist clinicians in decision-making for rehabilitation in lumbar surgery. Despite many of the recommendations relying exclusively on expert opinion rather than published evidence, this approach is an important advance to improve concordance among healthcare professionals.
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Affiliation(s)
- Arnaud Dupeyron
- Service de Médecine Physique et de Réadaptation, CHU Nîmes, Univ Montpellier, Nîmes, France.
| | - Patricia Ribinik
- Service de Médecine Physique et de Réadaptation, CH de Gonesse, Gonesse, France
| | - François Rannou
- Service de Rééducation et de Réadaptation de l'appareil locomoteur et des pathologies du Rachis, hôpitaux universitaires Paris centre-groupe hospitalier Cochin, AP-HP, Paris, France
| | - Sarah Kabani
- Service de Biostatistique, Epidémiologie, Santé Publique, Innovation Méthodologique (BESPIM), CHU Nîmes, Univ Montpellier, Nîmes, France
| | - Christophe Demoulin
- Department of Sport and Rehabilitation Sciences, University of Liege, Liege, Belgium
| | | | - Violaine Foltz
- Service de Rhumatologie, Hôpitaux universitaires Paris centre-groupe hospitalier Pitié-Salpétrière, AP-HP, Paris, France
| | - Joel Godard
- Service de Neurochirurgie et de chirurgie de la douleur et du rachis, CHRU Besançon, Université de Franche Comté, Besançon, France
| | - Jean Huppert
- Service de Neurochirurgie, Clinique du Parc, Saint-Priest-en-Jarez, France
| | - Julien Nizard
- Centre fédératif douleur soins de support, UIC 22, équipe mobile de soins palliatifs et de support, CHU Nantes, Nantes, France
| | - Audrey Petit
- Centre de consultation de pathologie professionnelle, CHU d'Angers, Angers, France
| | - Clement Silvestre
- Département de Chirurgie Orthopédique, Clinique Médico-Chirurgicale des Massues, Lyon, France
| | - Pascal Kouyoumdjian
- Service de Chirurgie Orthopédique, CHU Nîmes, Univ Montpellier, Nîmes, France
| | - Emmanuel Coudeyre
- Service de Médecine Physique et de Réadaptation, CHU Clermont-Ferrand, Université Clermont Auvergne, INRAE, UNH, F-63000 Clermont-Ferrand, France
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Salik Sengul Y, Kaya N, Yalcinkaya G, Kirmizi M, Kalemci O. The effects of the addition of motor imagery to home exercises on pain, disability and psychosocial parameters in patients undergoing lumbar spinal surgery: A randomized controlled trial. Explore (NY) 2020; 17:334-339. [PMID: 32147444 DOI: 10.1016/j.explore.2020.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 12/26/2019] [Accepted: 02/07/2020] [Indexed: 10/24/2022]
Abstract
CONTEXT Patients who have suffered from persistent symptoms often undergo lumbar spinal surgery (LSS). Motor imagery should be added to postoperative home exercises to reduce patient complaints. OBJECTIVE The aim of this study was to compare the effects of home exercise plus motor imagery and only home exercise in patients undergoing LSS. DESIGN A randomized controlled study. SETTINGS This study was designed by researchers at Dokuz Eylul University. PARTICIPANTS Thirty-seven patients undergoing LSS were randomized to motor imagery group (n = 19) and control group (n = 18). MAIN OUTCOME MEASURES Pain was measured by Visual Analogue Scale, disability related to low back pain by Oswestry Disability Index, pain-related fear by Tampa Scale of Kinesiophobia, depression by Beck Depression Inventory, quality of life by World Health Organization Quality of Life Scale-Short Form (WHOQOL-BREF). All assessments were repeated in the preoperative period, three weeks after and six weeks after the surgery. INTERVENTIONS Motor imagery group underwent home exercise plus motor imagery program applied by voice recording. Control group underwent only home exercise program. Exercise program compliance was monitored by exercise diary and telephone calls once every week. RESULTS There was a significant improvement in pain at rest and during activity, disability, kinesiophobia, depression, physical health and psychological sub-parameters of WHOQOL-BREF between preoperative period, and the third week and sixth week in both groups (p < 0.05). When comparing groups for gain scores, there was a more significant improvement in pain during activity in motor imagery group (p < 0.05). Motor imagery should be addressed as an effective treatment after LSS.
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Affiliation(s)
- Yesim Salik Sengul
- School of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey
| | - Nergis Kaya
- Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | - Gamze Yalcinkaya
- Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey.
| | - Muge Kirmizi
- Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey; Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University
| | - Orhan Kalemci
- Department of Neurosurgery, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
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Strøm J, Nielsen CV, Jørgensen LB, Andersen NT, Laursen M. A web-based platform to accommodate symptoms of anxiety and depression by featuring social interaction and animated information in patients undergoing lumbar spine fusion: a randomized clinical trial. Spine J 2019; 19:827-839. [PMID: 30500464 DOI: 10.1016/j.spinee.2018.11.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 11/26/2018] [Accepted: 11/26/2018] [Indexed: 02/03/2023]
Abstract
BACKGROUND Approximately one-third of patients undergoing spine surgery have symptoms of anxiety and depression that correlate with pain, disability, and lower health-related quality of life. The use of web-based informative strategies before surgery and principles from cognitive behavioral therapy, have been applied in other patient groups, facilitating mobility and encouraging beneficial coping behavior. PURPOSE To examine the effect of a web-based Spine Platform featuring Interaction and Information by Animation (w-SPIINA) on symptoms of anxiety and depression, pain, disability, and health-related quality of life. STUDY DESIGN A single-center, two-arm, randomized controlled trial PATIENT SAMPLE: One hundred fourteen consecutive patients scheduled for instrumented lumbar spine fusion due to degenerative disc disease or spondylolisthesis. OUTCOME MEASURES Primary outcome was the change in self-reported Hospital Anxiety and Depression Scale (HADS) scores from baseline to 3-month follow-up. Secondary outcomes were change in HADS 1-day before surgery 2days and 6 months after and changes in self-reported disability measured on the Oswestry disability index (ODI), quality of life (EQ-5D-5L questionnaire), and the low back pain rating scale (LBPRS) 2days and 3 and 6 months after surgery. METHOD Patients were randomized to either a control group receiving a standard information regimen or an intervention group gaining access to w-SPIINA in addition to the standard regimen. The independent charity Helsefonden contributed $45,000, the Health Research Fund of the Regional Hospital Central Jutland contributed $10,000, and the Toyota foundation contributed $10,000 to remunerate a dedicated investigator. The authors have no conflict of interest to declare. RESULTS There was no statistically significant difference within the w-SPIINA group and the control group regarding changes in HADS at 3-month follow-up (p≥.37). Approximately 40% reached minimum clinically important difference (MCID) in the w-SPIINA group on the HADS at 3 months. In the control group 50% reached MCID on anxiety subscale and 35% on the depression subscale at 3 months. No statistically significant differences were found between groups with regard to the overall outcomes at any of the predefined time points. CONCLUSION Providing patients with access to w-SPIINA in addition to a standard information regimen had no additional effect on HADS and patient-reported outcomes1day before, 2days, 3 or 6 months after surgery. However, a high compliance and degree of interaction with w-SPIINA indicates that this mode of web-based support could be applicable in this group of patients.
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Affiliation(s)
- Janni Strøm
- Centre of Elective Surgery, Regional Hospital of Silkeborg, Silkeborg, Denmark; Department of Public Health, Section for Clinical Social Medicine and Rehabilitation, Aarhus University, Aarhus, Denmark.
| | - Claus Vinther Nielsen
- Department of Public Health, Section for Clinical Social Medicine and Rehabilitation, Aarhus University, Aarhus, Denmark; DEFACTUM, Central Denmark Region, Denmark
| | - Lene Bastrup Jørgensen
- Centre of Elective Surgery, Regional Hospital of Silkeborg, Silkeborg, Denmark; Department of Clinical Medicine, Section for Public Health, Aarhus University, Aarhus, Denmark
| | - Niels Trolle Andersen
- Department of Biostatistics, Section for Public Health, Aarhus University, Aarhus, Denmark
| | - Malene Laursen
- Centre of Elective Surgery, Regional Hospital of Silkeborg, Silkeborg, Denmark
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Navarrete-Zampaña MDLD, Sellán-Soto MC, Díaz-Martínez ML. Painful experience in adolescents undergoing surgical correction of scoliosis. ENFERMERIA CLINICA 2019; 29:297-301. [PMID: 30685342 DOI: 10.1016/j.enfcli.2018.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 10/29/2018] [Accepted: 10/30/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of our study is to learn about the post-surgical pain experience in adolescents undergoing surgical correction of Adolescent Idiopathic Scoliosis (AIS). METHODS Qualitative study with an interpretative phenomenological approach. Through semi-structured interviews, 7 informants, women aged between 12 and 21, were interviewed between the third and fifth day after being surgically treated for AIS correction. The speeches were recorded and transcribed verbatim. Content Analysis method was used to analyse the discourse. RESULTS The categories established were: influential factors, values and ideas, coping mechanisms and improvement areas. Painful experience is a determining factor during recovery, influenced by the individuals themselves, as well as by the support received, and the environment. Their main values and ideas about the process are based on pre-surgical information, which they consider insufficient. In order to cope, they use of distraction, relaxation and drug consumption. According to the informants, increasing the information they are given about the process, facilitating visits and incorporating complementary techniques would improve pain control. CONCLUSIONS Pain is the main focus of the process and is influenced by several factors. The patients' coping mechanisms help in its management. They also put forward different improvement areas.
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Affiliation(s)
| | - María Carmen Sellán-Soto
- Red ENSI-España, Madrid, España; Profesora, doctora, Departamento de Enfermería, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, España
| | - María Luisa Díaz-Martínez
- Red ENSI-España, Madrid, España; Profesora, Departamento de Enfermería, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, España
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Vitoula K, Venneri A, Varrassi G, Paladini A, Sykioti P, Adewusi J, Zis P. Behavioral Therapy Approaches for the Management of Low Back Pain: An Up-To-Date Systematic Review. Pain Ther 2018; 7:1-12. [PMID: 29767395 PMCID: PMC5993685 DOI: 10.1007/s40122-018-0099-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Indexed: 01/21/2023] Open
Abstract
Low back pain is one of the most common causes for seeking medical treatment and it is estimated that one in two people will experience low back pain at some point during their lifetimes. Management of low back pain includes pharmacological and non-pharmacological approaches. Non-pharmaceutical treatments include interventions such as acupuncture, spinal manipulation, and psychotherapy. The latter is especially important as patients who suffer from low back pain often have impaired quality of life and also suffer from depression. Depressive symptoms can appear because back pain limits patients’ ability to work and engage in their usual social activities. The aim of this systematic review was to overview the behavioral approaches that can be used in the management of patients with low back pain. Approaches such as electromyography (EMG) biofeedback, cognitive behavioral therapy, and mindfulness-based stress reduction are discussed as non-pharmacological options in the management of low back pain.
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Affiliation(s)
- Kristallia Vitoula
- Department of Anesthesiology, Attica General Hospital KAT, Athens, Greece
| | - Annalena Venneri
- Department of Neurosciences, University of Sheffield, Sheffield, UK
| | | | | | | | - Joy Adewusi
- Academic Department of Neurosciences, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Panagiotis Zis
- Academic Department of Neurosciences, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
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Ilves O, Häkkinen A, Dekker J, Pekkanen L, Piitulainen K, Järvenpää S, Marttinen I, Vihtonen K, Neva MH. Quality of life and disability: can they be improved by active postoperative rehabilitation after spinal fusion surgery in patients with spondylolisthesis? A randomised controlled trial with 12-month follow-up. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2016; 26:777-784. [PMID: 27687823 DOI: 10.1007/s00586-016-4789-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 09/01/2016] [Accepted: 09/18/2016] [Indexed: 11/24/2022]
Abstract
PURPOSE The aim of the study was to investigate the effectiveness of the postoperative 12-month exercise program compared to usual care on disability and health-related quality of life (HRQoL) in patients after lumbar spine fusion surgery (LSF). METHODS Altogether, 98 patients with isthmic (31) or degenerative (67) spondylolisthesis were randomised to exercise therapy group (EG) (n = 48) or usual care group (UCG) (n = 50) 3 months after LSF. EG patients had home-based progressive strength and aerobic training program for 12 months. UCG patients received only oral and written instructions of exercises. Oswestry Disability Index (ODI) and HRQoL (RAND-36) were evaluated at the time of randomization, at the end of the intervention and 1 year after intervention. RESULTS The mean ODI score decreased from 24 (12) to 18 (14) in the EG and from 18 (12) to 13 (11) in the UCG during intervention (between-groups p = 0.69). At 1-year follow-up, 25 % of the EG and 28 % of the UCG had an ODI score ≥20. No between-group differences in HRQoL change were found at any time point. The mean (95 % CI) physical functioning dimension of the HRQoL improved by 10.0 (4.6-15.3) in the EG and by 7.8 (2.5-13.0) in the UCG. In addition, the role physical score improved by 20.0 (7.7-32.3) in the EG and by 16.4 (4.4-28.4) in the UCG during the intervention. CONCLUSIONS The exercise intervention did not have an impact on disability or HRQoL beyond the improvement achieved by usual care. However, disability remained at least moderate in considerable proportion of patients.
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Affiliation(s)
- Outi Ilves
- Department of Health Sciences, University of Jyväskylä, Viveca Building, P.O. Box 35, 40014, Jyväskylä, Finland.
- Department of Physical Medicine and Rehabilitation, Central Finland Health Care District, Keskussairaalantie 19, 40620, Jyväskylä, Finland.
| | - Arja Häkkinen
- Department of Health Sciences, University of Jyväskylä, Viveca Building, P.O. Box 35, 40014, Jyväskylä, Finland
- Department of Physical Medicine and Rehabilitation, Central Finland Health Care District, Keskussairaalantie 19, 40620, Jyväskylä, Finland
| | - Joost Dekker
- Department of Rehabilitation Medicine, VU University Medical Center, P.O. Box 7057, 1007MB, Amsterdam, The Netherlands
- Department of Psychiatry, VU University Medical Center, P.O. Box 7057, 1007MB, Amsterdam, The Netherlands
| | - Liisa Pekkanen
- Department of Orthopaedic Medicine, Central Finland Health Care District, Keskussairaalantie 19, 40620, Jyväskylä, Finland
| | - Kirsi Piitulainen
- Department of Health Sciences, University of Jyväskylä, Viveca Building, P.O. Box 35, 40014, Jyväskylä, Finland
- Department of Physical Medicine and Rehabilitation, Central Finland Health Care District, Keskussairaalantie 19, 40620, Jyväskylä, Finland
| | - Salme Järvenpää
- Department of Physical Medicine and Rehabilitation, Central Finland Health Care District, Keskussairaalantie 19, 40620, Jyväskylä, Finland
| | - Ilkka Marttinen
- Department of Orthopaedics and Trauma, Tampere University Hospital, P.O. BOX 2000, 33521, Tampere, Finland
| | - Kimmo Vihtonen
- Department of Orthopaedics and Trauma, Tampere University Hospital, P.O. BOX 2000, 33521, Tampere, Finland
| | - Marko H Neva
- Department of Orthopaedics and Trauma, Tampere University Hospital, P.O. BOX 2000, 33521, Tampere, Finland
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