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PREPARE: Pre-surgery physiotherapy for patients with degenerative lumbar spine disorder: a randomized controlled trial protocol
Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Primary Health Care in Central County.
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping.
Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care.ORCID iD: 0000-0003-3707-5869
Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Bond University, Australia.ORCID iD: 0000-0002-4318-9216
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2016 (English)In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 17, no 270Article in journal (Refereed) PublishedText
Abstract [en]

Background: 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. Methods: 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. Discussion: The study findings will help improve the treatment of patients with degenerative lumbar spine disorder scheduled for surgery.

Place, publisher, year, edition, pages
BIOMED CENTRAL LTD , 2016. Vol. 17, no 270
Keyword [en]
Low back pain; Physiotherapy; Stratification; Surgery; Function
National Category
Physiotherapy
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URN: urn:nbn:se:liu:diva-130385DOI: 10.1186/s12891-016-1126-4ISI: 000379714500001PubMedID: 27400960OAI: oai:DiVA.org:liu-130385DiVA: diva2:952738
Note

Funding Agencies|Faculty of Medicine and Health, Linkoping University; NHS FoU fond, County Council of Ostergotland

Available from: 2016-08-15 Created: 2016-08-05 Last updated: 2016-09-08

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Lindbäck, YvonneTropp, HansEnthoven, PaulAbbott, AllanÖberg, Birgitta
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Division of PhysiotherapyFaculty of Medicine and Health SciencesPrimary Health Care in Central CountyDivision of Clinical SciencesDepartment of Orthopaedics in LinköpingResearch & Development Unit in Local Health Care
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BMC Musculoskeletal Disorders
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