This article is more than 5 years old. Information may no longer be current.
Fusion patients report less pain, more activity after ‘social’ rehab
Exercises and group meetings were more effective than the current protocol of exercises alone.
Click Here to Manage Email Alerts
NANTES, France — Two years after lumbar fusion surgery, patients who viewed and performed videotaped rehabilitation exercises and regularly met at a “back café” with other fusion patients had better outcomes than patients who underwent two other rehabilitation programs.
According to Finn B. Christensen, MD, back café participants did better than the patients in the other two groups at two-year follow-up in terms of pain. Their ability to work a full day without low back pain (LBP) was significantly better. “The coffee group came out 5% better than the other two groups,” he said.
Christensen and his co-investigators in the spine unit of the department of orthopaedics at the University of Aarhus, Denmark, conducted a prospective randomized study to analyze the effect of three different postoperative rehabilitation strategies on lumbar spinal fusion patients. Included in the study were 90 patients who were operated on due to chronic LBP from 1996 to September 1999. Their symptoms persisted for more than two years.
Videotaped exercises
At three months postop, patients were randomized to one of three groups. The video group viewed a videotape demonstrating rehabilitation exercises and received instruction on performing them during a one-hour training program. This was the standard rehabilitation protocol at Christensen’s institution at the time.
Patients in the coffee group viewed the video and participated in a back café — a 1½-hour meeting with other lumbar fusion patients and a physical therapist held three times over an eight-week period. Those randomized to the training group underwent a structured physical therapy training program consisting of endurance training and stretching exercises twice weekly for eight weeks.
Christensen presented results of the study during the 4th Annual Meeting of the Spine Society of Europe.
Investigators measured outcomes with a low back pain scale that rated back and leg pain. The patient’s propensity for daily living, psychological capacity, back strain at home, work status and need to access primary back-related health care were also assessed.
Back café effective at 24 months
One patient in the video group and four each in the coffee and training groups dropped out of the study. This left 29 patients in the video group and 26 patients each in the coffee and training groups (90%) who completed the entire follow-up.
All patients improved significantly until the three-month follow-up in terms of back and leg pain, Christensen said. “At index, there was more pain in the video and the coffee groups, but when we came to the 24-month follow-up, the coffee group was doing best (P<0.03),” he said.
“The patients in the back café were significantly better at accomplishing a succession of daily tasks and had less pain compared to the video and training group two years after lumbar spinal fusion,” Christensen said.
For your information:
- Christensen FB, Laurberg I, Andersen T, Bünger C. Effect evaluation of 3 rehabilitation programs after lumber spinal fusion. A randomized prospective study with a 2-year follow-up. #61. Presented at the 4th Annual Meeting of the Spine Society of Europe. Sept. 11-14, 2002. Nantes, France.