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https://hdl.handle.net/2440/60878
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Type: | Journal article |
Title: | Function after spinal treatment, exercise and rehabilitation (FASTER): Improving the functional outcome of spinal surgery |
Author: | McGregor, A. Doré, C. Morris, T. Morris, S. Jamrozik, K. |
Citation: | BMC Musculoskeletal Disorders, 2010; 11(17):1-8 |
Publisher: | BioMed Central Ltd. |
Issue Date: | 2010 |
ISSN: | 1471-2474 1471-2474 |
Statement of Responsibility: | A. H. McGregor, C. J. Doré, T. P. Morris, S. Morris and K. Jamrozik |
Abstract: | BACKGROUND: The life-time incidence of low back pain is high and diagnoses of spinal stenosis and disc prolapse are increasing. Consequently, there is a steady rise in surgical interventions for these conditions. Current evidence suggests that while the success of surgery is incomplete, it is superior to conservative interventions. A recent survey indicates that there are large differences in the type and intensity of rehabilitation, if any, provided after spinal surgery as well as in the restrictions and advice given to patients in the post-operative period. This trial will test the hypothesis that functional outcome following two common spinal operations can be improved by a programme of post-operative rehabilitation that combines professional support and advice with graded active exercise and/or an educational booklet based on evidence-based messages and advice. METHODS/DESIGN: The study design is a multi-centre, factorial, randomised controlled trial with patients stratified by surgeon and operative procedure. The trial will compare the effectiveness and cost-effectiveness of a rehabilitation programme and an education booklet for the postoperative management of patients undergoing discectomy or lateral nerve root decompression, each compared with "usual care"using a 2 x 2 factorial design. The trial will create 4 sub-groups; rehabilitation-only, booklet-only, rehabilitation-plus-booklet, and usual care only. The trial aims to recruit 344 patients, which equates to 86 patients in each of the four sub-groups. All patients will be assessed for functional ability (through the Oswestry Disability Index - a disease specific functional questionnaire), pain (using visual analogue scales), and satisfaction pre-operatively and then at 6 weeks, 3, 6 and 9 months and 1 year post-operatively. This will be complemented by a formal analysis of cost-effectiveness. DISCUSSION: This trial will determine whether the outcome of spinal surgery can be enhanced by either a post-operative rehabilitation programme or an evidence-based advice booklet or a combination of the two and as such will contribute to our knowledge on how to manage spinal surgery patients in the post-operative period. |
Keywords: | Humans Spinal Stenosis Radiculopathy Postoperative Complications Treatment Outcome Postoperative Period Counseling Exercise Exercise Therapy Rehabilitation Self Care Decompression, Surgical Neurosurgical Procedures Patient Compliance Pamphlets Activities of Daily Living Patient Education as Topic Lumbar Vertebrae Diskectomy Low Back Pain Research Design Patient Selection Time Factors Quality of Life Outcome Assessment (Health Care) Disability Evaluation Intervertebral Disc Displacement Physical Fitness |
Rights: | © 2010 McGregor et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the CreativeCommons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, andreproduction in any medium, provided the original work is properly cited. |
DOI: | 10.1186/1471-2474-11-17 |
Published version: | http://dx.doi.org/10.1186/1471-2474-11-17 |
Appears in Collections: | Aurora harvest 7 General Practice publications |
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hdl_60878.pdf | 406.48 kB | Adobe PDF | View/Open |
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