Department of Orthopaedics and Research School Caphri, Maastricht University Medical Center, Maastricht; Department of Orthopaedics, VieCuri Medical Center, Venlo.
GROW-School for Oncology and Developmental Biology, Department of Radiation Oncology (MAASTRO), Maastricht University Medical Center, Maastricht.
Arch Phys Med Rehabil. 2021 Jul;102(7):1324-1330.e3. doi: 10.1016/j.apmr.2021.02.013. Epub 2021 Mar 9.
To explore the association between preoperative physical performance with short- and long-term postoperative outcomes in patients undergoing lumbar spinal fusion (LSF).
Retrospective cohort.
University hospital.
Seventy-seven patients (N=77) undergoing elective LSF were preoperatively screened on patient demographics, patient-reported outcome measures, and physical performance measures (movement control, back muscle endurance strength and extensor strength, aerobic capacity, flexibility).
Not applicable.
Associations between preoperative variables and inpatient functional recovery, hospital length of stay (LOS), and 1- to 2-year postoperative pain reduction were explored using random forest analyses assessing the relative influence of the variable on the outcome.
Aerobic capacity was associated with fast functional recovery <4 days and prolonged functional recovery >5 days (median z scores=7.1 and 12.0). Flexibility (median z score=4.3) and back muscle endurance strength (median z score=7.8) were associated with fast functional recovery <4 days. Maximum back extensor strength was associated with prolonged functional recovery >5 days (median z score=8.6). Flexibility (median z score=5.1) and back muscle endurance strength (median z score=13.5) were associated with short LOS <5 days. Aerobic capacity (median z score=8.7) was associated with prolonged LOS >7 days. Maximum back extensor strength (median z score=3.8) was associated with 1- to 2-year postoperative pain reduction and aerobic capacity (median z score=2.8) was tentative.
Physical performance measures were associated with both short- and long-term outcomes after LSF. Adding these measures to prediction models predicting outcomes after LSF may increase their accuracy.
探讨腰椎融合术（LSF）患者术前身体机能与短期和长期术后结果的相关性。
回顾性队列研究。
大学医院。
77 例接受择期 LSF 的患者，术前对患者的人口统计学、患者报告的结果测量和身体机能测量（运动控制、腰背肌耐力强度和伸肌强度、有氧能力、柔韧性）进行了筛查。
无。
使用随机森林分析评估变量对结果的相对影响，探讨术前变量与住院期间功能恢复、住院时间（ LOS ）和 1 至 2 年术后疼痛减轻的相关性。
有氧能力与 4 天内快速功能恢复和 5 天以上功能恢复延长相关（中位数 z 分数分别为 7.1 和 12.0）。柔韧性（中位数 z 分数=4.3）和腰背肌耐力强度（中位数 z 分数=7.8）与 4 天内快速功能恢复相关。最大背伸肌力量与 5 天以上功能恢复延长相关（中位数 z 分数=8.6）。柔韧性（中位数 z 分数=5.1）和腰背肌耐力强度（中位数 z 分数=13.5）与 LOS<5 天的缩短相关。有氧能力（中位数 z 分数=8.7）与 LOS>7 天的延长相关。最大背伸肌力量（中位数 z 分数=3.8）与 1 至 2 年术后疼痛减轻相关，而有氧能力（中位数 z 分数=2.8）则存在关联。
身体机能测量与 LSF 后的短期和长期结果均相关。在预测 LSF 术后结果的预测模型中加入这些指标可能会提高其准确性。
