Telehealth physical activity may improve function after laminectomy with or without fusion
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Key takeaways:
- Telehealth physical activity after laminectomy with or without fusion yielded more physical activity per day vs. usual care.
- The telehealth group had better function, back pain relief and return to activity.
Presented results showed a telehealth physical activity intervention in patients with lumbar degenerative conditions may improve physical function, back pain and return to activity 6 months after laminectomy with or without fusion.
“This is a feasible, low-cost intervention. There are patients that live in areas where they cannot access in-person rehabilitation or go to a gym,” Kristin A. Archer, PhD, DPT, professor and vice chair of research in the department of orthopedic surgery and director of the Vanderbilt Center for Musculoskeletal Research at Vanderbilt University Medical Center, told Healio about results presented at the North American Spine Society Annual Meeting. “Something easy like wearing an activity watch or Fitbit (Google) that can get [patients] thinking about their activity seems to be beneficial and can improve outcomes.”
Telehealth intervention
Archer and colleagues randomly assigned patients with lumbar degenerative conditions undergoing laminectomy with or without fusion to postoperatively receive either a telehealth physical activity intervention (n = 30) or usual care (n = 30). According to the abstract, patients in the telehealth group received a wearable device (Fitbit Inspire HR, Google) and a daily activity tracking sheet 2 weeks after surgery. They were also scheduled for telehealth counseling by a licensed physical therapist trained in motivational interviewing.
“We had a physical therapist talk to patients once a week for 8 weeks while they were wearing their Fitbit,” Archer said. “This was after spine surgery, and it helped patients think about their physical activity [and] set goals around physical activity so they could increase it early after surgery.”
Archer said they objectively measured physical activity with an accelerometer and collected patient questionnaires on physical function, pain and disability after surgery.
Results showed patients in the telehealth group had higher activity counts per day and time spent in moderate-to-vigorous physical activity at 6-month follow-up. Patients in the telehealth group also had a 3.9-point higher Patient-Reported Outcomes Measurement Information System physical function score, back pain that was 1.2 points lower and were six times more likely to return to physical activity at 6 months compared with the usual care group.
Increased physical activity
Archer said patients in the telehealth group reported better physical function, disability, back pain and leg pain relief, and return to activity. However, significant differences across groups were found for only physical function and back pain at 6 months.
“The improvements in disability and leg pain were smaller than for the other outcomes. We likely did not have enough people in the study to find out whether these differences were significant or clinically meaningful,” Archer said. “A larger study is needed to better understand improvements in patient-reported outcomes and to discover what forms of physical activity are the most relevant and meaningful for patients after spine surgery. Some people found it easy to set daily walking goals while others wanted to focus on riding a bike, swimming or doing exercises at home.”
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Archer KR, et al. Physical activity intervention to improve surgical spine outcomes (PASS Trial). Presented at: North American Spine Society Annual Meeting; Sept. 23-28, 2024; Chicago.
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