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Lawrence DC, Montazeripouragha A, Wai EK, Roffey DM, Phan KM, Phan P, Stratton A, Kingwell S, McIntosh G, Soroceanu A, Abraham E, Bailey CS, Christie S, Paquet J, Glennie A, Nataraj A, Hall H, Fisher C, Rampersaud YR, Thomas K, Manson N, Johnson M, Zarrabian M. Beneficial Effects of Preoperative Exercise on the Outcomes of Lumbar Fusion Spinal Surgery. Physiother Can 2023; 75:22-28. [PMID: 37250725 PMCID: PMC10211389 DOI: 10.3138/ptc-2021-0030] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 08/03/2021] [Accepted: 08/18/2021] [Indexed: 02/11/2024]
Abstract
Purpose: To determine whether there was an association between self-reported preoperative exercise and postoperative outcomes after lumbar fusion spinal surgery. Method: We performed a retrospective multivariable analysis of the prospective Canadian Spine Outcomes and Research Network (CSORN) database of 2,203 patients who had elective single-level lumbar fusion spinal surgeries. We compared adverse events and hospital length of stay between patients who reported regular exercise (twice or more per week) prior to surgery ("Regular Exercise") to those exercising infrequently (once or less per week) ("Infrequent Exercise") or those who did no exercise ("No Exercise"). For all final analyses, we compared the Regular Exercise group to the combined Infrequent Exercise or No Exercise group. Results: After making adjustments for known confounding factors, we demonstrated that patients in the Regular Exercise group had fewer adverse events (adjusted odds ratio 0.72; 95% CI: 0.57, 0.91; p = 0.006) and significantly shorter lengths of stay (adjusted mean 2.2 vs. 2.5 d, p = 0.029) than the combined Infrequent Exercise or No Exercise group. Conclusions: Patients who exercised regularly twice or more per week prior to surgery had fewer postoperative adverse events and significantly shorter hospital lengths of stay compared to patients that exercised infrequently or did no exercise. Further study is required to determine effectiveness of a targeted prehabilitation programme.
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Affiliation(s)
| | | | - Eugene K. Wai
- The Ottawa Hospital, Ottawa, Ontario, Canada
- Division of Orthopaedic Surgery, University of Ottawa, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- Ottawa Health Research Institute, Clinical Epidemiology Program, Ottawa, Ontario, Canada
| | - Darren M. Roffey
- The Ottawa Hospital, Ottawa, Ontario, Canada
- Ottawa Health Research Institute, Clinical Epidemiology Program, Ottawa, Ontario, Canada
| | - Kim M. Phan
- The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Philippe Phan
- The Ottawa Hospital, Ottawa, Ontario, Canada
- Division of Orthopaedic Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - Alexandra Stratton
- The Ottawa Hospital, Ottawa, Ontario, Canada
- Division of Orthopaedic Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - Stephen Kingwell
- The Ottawa Hospital, Ottawa, Ontario, Canada
- Division of Orthopaedic Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - Greg McIntosh
- Research Operations, Canadian Spine Outcomes Research Network, Markdale, Ontario, Canada
| | - Alex Soroceanu
- University of Calgary, Foothills Medical Centre, Calgary, Alberta, Canada
| | - Edward Abraham
- Canada East Spine Center and Horizon Health Network, Dalhousie University, Saint John, New Brunswick, Canada
| | - Christopher S. Bailey
- Lawson Health Research Institute/London Health Sciences Centre, Division of Orthopaedics, Department of Surgery, Western University, London, Ontario, Canada
| | - Sean Christie
- Department of Surgery, Division of Neurosurgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jerome Paquet
- Hôpital de l’Enfant-Jésus, Laval University, Quebec City, Quebec, Canada
| | - Andrew Glennie
- Department of Surgery, Division of Orthopedics, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Hamilton Hall
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Charles Fisher
- Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, British Columbia, Canada
| | - Y. Raja Rampersaud
- Arthritis Program, Krembil Research Institute, University Health Network, Department of Surgery, Division of Orthopaedic Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Kenneth Thomas
- University of Calgary, Foothills Medical Centre, Calgary, Alberta, Canada
| | - Neil Manson
- Canada East Spine Center and Horizon Health Network, Dalhousie University, Saint John, New Brunswick, Canada
| | - Michael Johnson
- Winnipeg Spine Program Health Sciences Centre, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Mohammad Zarrabian
- Winnipeg Spine Program Health Sciences Centre, University of Manitoba, Winnipeg, Manitoba, Canada
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