Department of Chiropractic, Université du Québec à Trois-Rivières, 3351 Boul. des Forges, Trois-Rivières, QC, G9A 5H7, Canada.
Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, Canada.
Sci Rep. 2021 May 26;11(1):11080. doi: 10.1038/s41598-021-90537-4.
Lumbar spinal stenosis is the most common reason for spine surgery in older adults, but the effects of prehabilitation on perioperative outcomes among these patients have not been investigated. This study aims to evaluate the effectiveness of a preoperative exercise-based intervention program compared with usual care on the improvement of clinical status, physical capacities and postoperative recovery of patients awaiting surgery for lumbar spinal stenosis. Sixty-eight participants were randomised to receive either a 6-week supervised exercise-based prehabilitation program or hospital usual care. The outcomes included both clinical and physical measures. Data collection occurred at post-intervention, and 6 weeks, 3- and 6-months post-surgery. Significant but small improvements were found in favour of the experimental group at the post-intervention assessment for pain intensity, lumbar spinal stenosis-related disability, lumbar strength in flexion, low back extensor muscles endurance, total ambulation time, and sit to stand performance. A significant difference in favor of the intervention group was found starting at the 3-month postoperative follow-up for low back-related disability. No adverse events were reported. Exercise-based prehabilitation did not improve short-term postoperative recovery in patients with lumbar spinal stenosis.
腰椎管狭窄症是老年人脊柱手术最常见的原因，但术前康复对这些患者围手术期结局的影响尚未得到研究。本研究旨在评估与常规护理相比，术前基于运动的干预方案对等待腰椎管狭窄症手术的患者临床状况、身体能力和术后恢复的改善效果。68 名参与者被随机分配接受 6 周的监督性基于运动的术前康复计划或医院常规护理。结果包括临床和身体测量。数据收集发生在干预后、术后 6 周、3 个月和 6 个月。在干预后评估中，实验组在疼痛强度、腰椎管狭窄症相关残疾、腰椎屈伸力量、下背部伸肌耐力、总步行时间和坐立起身表现方面均有显著但较小的改善。从术后 3 个月随访开始，干预组在与下背部相关的残疾方面的差异有统计学意义。未报告不良事件。基于运动的术前康复并不能改善腰椎管狭窄症患者的短期术后恢复。
