Reyes Justin L, Coury Josephine R, Dionne Alexandra, Miller Roy, Katiyar Prerana, Smul Abigail, Bakarania Prachi, Lombardi Joseph M, Sardar Zeeshan M
The Och Spine Hospital, New York-Presbyterian/Columbia University Irving Medical Center, 5141 Broadway, 3 Field West, New York, NY, 10034, USA.
Conservative Care for Spine and Scoliosis/ Columbia University Irving Medical Center, New York, NY, USA.
Spine Deform. 2024 Sep;12(5):1261-1267. doi: 10.1007/s43390-024-00893-0. Epub 2024 May 24.
Postoperative physical therapy (PT) is a cornerstone of orthopedic and musculoskeletal rehabilitation, proven to provide various positive clinical benefits. However, there is a paucity of literature evaluating the utility of preoperative rehabilitation specific to spine surgery. Thus, this review article aims to provide an overview of previously published studies discussing the efficacy of preoperative rehabilitation programs and its role in spinal surgery. Special emphasis was given to preoperative frailty assessments, physical performance tests, interventional strategies, feasibility, and future directions.
We performed a literature review using PubMed, Google Scholar, EMBASE, and PubMed Central (PMC) using directed search terms. Articles that examined preoperative rehabilitation in adult spine surgery were compiled for this review. Prehabilitation programs focused on exercise, flexibility, and behavioral modifications have been shown to significantly improve pain levels and functional strength assessments in patients undergoing elective spine surgery. In addition, studies suggest that these programs may also decrease hospital stays, return to work time, and overall direct health care expenditure costs. Screening tools such as the FRAIL scale can be used to assess frailty while physical function tests like the timed-up-and go (TUGT), 5 repetition sit-to-stand test (5R-STST), and hand grip strength (HGS) can help identify patients who would most benefit from prehabilitation.
This review illustrates that prehabilitation programs have the potential to increase quality of life, improve physical function and activity levels, and decrease pain, hospital stays, return to work time, and overall direct costs. However, there is a paucity of literature in this field that requires further study and investigation.
术后物理治疗（PT）是骨科和肌肉骨骼康复的基石，已被证明能带来多种积极的临床益处。然而，评估脊柱手术术前康复效用的文献却很匮乏。因此，这篇综述文章旨在概述此前发表的有关术前康复计划疗效及其在脊柱手术中作用的研究。特别强调了术前衰弱评估、身体机能测试、干预策略、可行性及未来方向。
我们使用定向检索词，通过PubMed、谷歌学术、EMBASE和PubMed Central（PMC）进行文献综述。本综述汇编了研究成人脊柱手术术前康复的文章。以运动、灵活性和行为改变为重点的术前康复计划已被证明能显著改善择期脊柱手术患者的疼痛程度和功能强度评估。此外，研究表明这些计划还可能缩短住院时间、减少重返工作岗位所需时间以及降低总体直接医疗费用。诸如衰弱量表（FRAIL scale）等筛查工具可用于评估衰弱程度，而诸如计时起立行走测试（TUGT）、5次坐立试验（5R - STST）和握力测试（HGS）等身体功能测试有助于识别最能从术前康复中获益的患者。
本综述表明，术前康复计划有潜力提高生活质量、改善身体功能和活动水平，并减轻疼痛、缩短住院时间、减少重返工作岗位所需时间以及降低总体直接费用。然而，该领域的文献匮乏，需要进一步研究和调查。
