G5 Doctoral dissertation (article)
Rehabilitation after lumbar spine fusion : the effectiveness of a 12-month home-exercise program (2020)

Ilves, O. (2020). Rehabilitation after lumbar spine fusion : the effectiveness of a 12-month home-exercise program [Doctoral dissertation]. Jyväskylän yliopisto. JYU Dissertations, 258. http://urn.fi/URN:ISBN:978-951-39-8244-7

JYU authors or editors

Publication details

All authors or editors: Ilves, Outi

eISBN: 978-951-39-8244-7

Journal or series: JYU Dissertations

eISSN: 2489-9003

Publication year: 2020

Number in series: 258

Number of pages in the book: 1 verkkoaineisto (99 sivua, 46 sivua useina numerointijaksoina, 4 numeroimatonta sivua)

Publisher: Jyväskylän yliopisto

Place of Publication: Jyväskylä

Publication country: Finland

Publication language: English

Persistent website address: http://urn.fi/URN:ISBN:978-951-39-8244-7

Publication open access: Openly available

Publication channel open access: Open Access channel

Abstract

The aim of this thesis was to study the recovery of trunk muscle strength and spine function after lumbar spine fusion surgery (LSF) and standard care, and to evaluate the effectiveness of a 12-month home-exercise program in the postoperative rehabilitation after LSF. Recovery was studied in a one-year prospective cohort study in consecutive patients undergoing non-urgent LSF (N=194, 66% women, mean age 61 years). The effectiveness of rehabilitation was studied in a randomized controlled trial of 98 patients with spondylolisthesis (75% women, mean age 59 years) who were allocated three months after LSF to the exercise group (EG) or to the usual care group (UCG). The EG underwent a 12-month training that consisted of back-specific and aerobic training including six booster sessions with a physiotherapist. The UCG underwent one guided session for light home exercises. The outcomes were isometric maximal strength of abdominal and back muscles, back muscle endurance, the Oswestry Disability Index, the Visual Analogue Scale for low back and leg pain intensities the RAND-36 for health-related quality of life, the Tampa Scale for Kinesiophobia and the International Physical Activity Questionnaire. Although some improvement occurred in the one-year prospective follow-up from preoperative level, the trunk muscle strength remained low and the trunk extension and flexion strength ratio imbalanced. After a one-year rehabilitation, no between-group differences were found in any outcomes. Both groups improved their trunk muscle strength, disability and physical functioning-related dimensions of health-related quality of life and increased their physical activity. The low back and leg pain intensities as well as degree of kinesiophobia were low three months after surgery, and they remained rather unchanged during the intervention. In conclusion, LSF patients had trunk muscle strength deficits and imbalance preoperatively and at one year of follow-up after surgery with standard care. The postoperative 12-month home-exercise after LSF did not bring significant additional benefits compared to usual care. Further, individual variation in all outcomes were large in both groups. Thus, it is important to find those patients with delayed recovery who need more individualized rehabilitation.

Keywords: back; spinal diseases; surgical treatment; rehabilitation; physiotherapy; pain; physical functioning; muscle strength; physical activity; quality of life

Free keywords: rehabilitation; lumbar spine fusion; trunk muscle strength; pain; disability; health-related quality of life; physical activity

Contributing organizations

Ministry reporting: Yes

Reporting Year: 2020