Neuro Spine Clinic, Prince of Wales Private Hospital, Randwick, New South Wales, Australia; Department of Neurosurgery, The University of New South Wales (UNSW), Sydney, Australia; These authors contributed equally.
Neuro Spine Clinic, Prince of Wales Private Hospital, Randwick, New South Wales, Australia; Department of Neurosurgery, The University of New South Wales (UNSW), Sydney, Australia.
Global Spine J. 2016 Aug;6(5):459-64. doi: 10.1055/s-0035-1565259. Epub 2015 Oct 13.
Prospective observational study.
Patient-based subjective ratings of symptoms and function have traditionally been used to gauge the success and extent of recovery following spine surgery. The main drawback of this type of assessment is the inherent subjectivity involved in patient scoring. We aimed to objectively measure functional outcome in patients having lumbar spine surgery using quantitative physical activity measurements derived from accelerometers.
A prospective study of 30 patients undergoing spine surgery was conducted with subjective outcome scores (visual analog scale [VAS], Oswestry Disability Index [ODI] and Short Form 12 [SF-12]) recorded; patients were given a Fitbit accelerometer (Fitbit Inc., San Francisco, California, United States) at least 7 days in advance of surgery to record physical activity (step count, distance traveled, calories burned) per day. Following surgery, postoperative activity levels were reported at 1-, 2-, and 3-month follow-up.
Of the 28 compliant patients who completed the full trial period, mean steps taken per day increased 58.2% (p = 0.008) and mean distance traveled per day increased 63% (p = 0.0004) at 3-month follow-up. Significant improvements were noted for mean changes in VAS back pain, VAS leg pain, ODI, and SF-12 Physical Component Summary (PCS) scores. There was no significant correlation between the improvement in steps or distance traveled per day with improvements in VAS back or leg pain, ODI, or PCS scores at follow-up.
High compliance and statistically significant improvement in physical activity were demonstrated in patients who had lumbar decompression and lumbar fusion. There was no significant correlation between improvements in subjective clinical outcome scores with changes in physical activity measurements at follow-up. Limitations of the present study include its small sample size, and the validity of objective physical activity measurements should be assessed in future larger, prospective studies.
前瞻性观察研究。
基于患者的症状和功能主观评分一直被用于评估脊柱手术后的成功和恢复程度。这种评估类型的主要缺点是患者评分中固有的主观性。我们旨在使用加速度计得出的定量身体活动测量值客观地衡量接受腰椎手术的患者的功能结果。
对 30 例接受脊柱手术的患者进行前瞻性研究，记录主观结果评分（视觉模拟评分[VAS]、Oswestry 残疾指数[ODI]和 12 项简短健康调查[SF-12]）；患者在手术前至少 7 天被给予 Fitbit 加速度计（加利福尼亚州旧金山的 Fitbit Inc.），以记录每天的身体活动（步数、行驶距离、消耗的卡路里）。手术后，在 1、2 和 3 个月的随访时报告术后活动水平。
在完成整个试验期的 28 名依从性患者中，每天的平均步数增加了 58.2%（p=0.008），每天的平均行驶距离增加了 63%（p=0.0004），在 3 个月的随访时。VAS 腰痛、VAS 腿痛、ODI 和 SF-12 物理成分综合评分的平均变化均有显著改善。在随访时，每天的步数或行驶距离的改善与 VAS 腰痛或腿痛、ODI 或 PCS 评分的改善之间没有显著相关性。
在接受腰椎减压和腰椎融合术的患者中，表现出高度的依从性和身体活动的统计学显著改善。在随访时，主观临床结果评分的改善与身体活动测量值的变化之间没有显著相关性。本研究的局限性包括样本量小，应在未来更大的前瞻性研究中评估客观身体活动测量的有效性。
