Postoperative rehabilitation does not improve functional outcome in lumbar spinal stenosis: a prospective study with 2-year postoperative follow-up |
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Authors: | Timo J. Aalto Ville Leinonen Arto Herno Markku Alen Heikki Kr?ger Veli Turunen Sakari Savolainen Tapani Saari Olavi Airaksinen |
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Affiliation: | (1) Kyyhkyl? Rehabilitation Center and Hospital/Hallinto, Kyyhkyl?ntie 9, 50700 Mikkeli, Finland;(2) Department of Neurosurgery, Kuopio University Hospital, Kuopio, Finland;(3) Department of Physical and Rehabilitation Medicine, Kuopio University Hospital, Kuopio, Finland;(4) Department of Medical Rehabilitation, Oulu University Hospital, Oulu, Finland;(5) Institute of Health Sciences, University of Oulu, Oulu, Finland;(6) Department of Orthopaedics and Traumatology, Kuopio University Hospital, Kuopio, Finland;(7) Bone Cartilage Research Unit, University of Eastern Finland (UEF), Kuopio Campus, Kuopio, Finland;(8) Rissalantie 36, 70910 Vuorela, Siilinj?rvi, Finland |
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Abstract: | The aim was to study if postoperative rehabilitation improves functional outcome in lumbar spinal stenosis (LSS). Surgically treated LSS patients (n = 102) were randomized to rehabilitation-group (A) and “standard postoperative treatment”—group (B). Intervention for A-group started 3 months postoperatively, consisting of once a week outpatient visits for 12 weeks (1.5 h per visit; 1–6 patients per one physiotherapist). Physiotherapist guided stretching and strengthening exercises. A-group performed individually estimated exercises at those visits with guiding and at home up to 24-month postoperative follow-up. Physiotherapeutic guidance (12 times) was repeated after 12 months, in order to update exercises and motivate patients to keep training. For B-group, the “standard treatment” thus included normal postoperative treatment, or no treatment/self-management. Outcome measures were measured at the start and the end of the first physiotherapeutic intervention (3 and 6 months postoperatively), and at 12- and 24-month postoperative follow-ups. Oswestry Disability Index (ODI, 0–100%) was the main outcome measure. The other outcome measures were back- and leg pain separately (NRS-11); satisfaction (7-point scale) and treadmill test (0–1,000 m; not at 6 month). The intervention consisting of 12 + 12 physiotherapeutic sessions with further home exercises did not influence the course ODI in the 24-month postoperative follow-up (p = 0.95 for ODI; “as-rehabilitated” analysis). No influence on any other outcome measures was observed. After LSS surgery, routinely performed outpatient rehabilitation did not improve functional outcome compared to standard treatment. In addition, it had no impact on the back and leg pain, satisfaction and walking ability. |
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Keywords: | Lumbar stenosis Surgery Outcome Rehabilitation |
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