Physiotherapists' prognosis of 1-year outcome after lumbar spinal fusion - A prospective cohort study

• Published in: Physiotherapy theory and practice Vol. 39; no. 8; pp. 1692 - 1703
• Main Authors: Tegner, Heidi, Garval, Mette, Rolving, Nanna, Esbensen, Bente Appel, Bech-Azeddine, Rachid, Henriksen, Marius
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis Ltd 03.08.2023
• Subjects: Back pain; Back surgery; Cohort analysis; Disability; Health status; Medical prognosis; Mobilization; Physical therapists; Postoperative care; Quality of life; Rehabilitation; Surgery; Visual analogue scales; rehabilitation; low back pain; Physiotherapy; surgery
• ISSN: 0959-3985; 1532-5040
• DOI: 10.1080/09593985.2022.2042880

Physiotherapists (PTs) have an essential role in the facilitation of patients' mobilization after lumbar spinal fusion (LSF). The aim of this study is to investigate whether PTs can predict one-year post-surgery outcome based on their first meeting with the patient immediately after LSF. A prospective cohort study with one-year follow-up was conducted. In the first days after surgery, the PTs from hospital wards were asked to predict the patients' overall LSF outcome one year after surgery. One year after surgery, the patients received a questionnaire including the Oswestry Disability Index (ODI), visual analogue scales (VAS) for leg and back pain, quality of life survey (EQ-5D-3 L), global perceived effect (GPA), and satisfaction with surgery outcome (SSO). Univariate and logistic regression were used to calculate the associations between the prognosis and predictive values. The study included 170 patients. The analyses showed a significant association between the PTs' prognosis and the primary outcome ODI (p < .01), VAS leg and back, EQ-5D-3 L, and GPE one-year post-surgery (p ≤ .04). However, the predictive value of the PTs' prognosis was low (R  ≤ 0.09). There was no significant association between the PTs' prognosis and the patients' SSO (p = .17; R  = 0.01). There were significant associations between the PTs' prognosis and disability, pain, health-related quality of life and global perceived effect one-year post-surgery, although the associations had low predictive values. There was no significant association between the PTs' prognosis and patients' SSO after one year. The PTs' prognosis should not be used as a single component in further rehabilitation planning.