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Physiotherapeutic Rehabilitation Following Lumbar Total Disc Replacement: A Retrospective Study
Author(s) -
Green Adeline,
Gilbert Philippa,
ScottYoung Matthew,
Abbott Allan
Publication year - 2016
Publication title -
physiotherapy research international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.509
H-Index - 49
eISSN - 1471-2865
pISSN - 1358-2267
DOI - 10.1002/pri.1630
Subject(s) - oswestry disability index , medicine , physical therapy , visual analogue scale , rehabilitation , lumbar , retrospective cohort study , low back pain , observational study , physical medicine and rehabilitation , surgery , alternative medicine , pathology
Background and Purpose This study sought to answer the following questions: What are the outcomes of physiotherapy post lumbar total disc replacement (LTDR) compared with patient self‐mediated rehabilitation? Is a difference in outcomes related to the number of physiotherapy sessions? Methods This is a retrospective observational study of 600 patients post TDR. Patient outcomes for self‐mediated rehabilitation (Group 1), 1–3 sessions of clinic‐based physiotherapy (Group 2) and ≥4 sessions of clinic‐based physiotherapy (Group 3) were analysed. Outcomes measures included the Oswestry Disability Index (ODI), Roland Morris Disability Questionnaire (RMQ), Short Form‐36 Physical (SF‐36 PCS) and Mental Subscale Components (SF‐36 MCS), Visual Analogue Scale (VAS) for back and leg pain intensity. Patient's pre‐operative baseline measures and post‐operative follow‐up measures at 3, 6, 12 and 24 months post‐operatively were analysed. Results Oswestry Disability Index and RMQ had significantly lower scores in Group 3 compared with Group 1 at 3, 6, 12 and 24 months follow‐up. Significantly lower scores for Group 2 compared with Group 1 were observed for the ODI at 3 months follow‐up and for the RMQ at 3 and 6 months follow‐up. Significantly lower scores were observed in Group 3 compared with Group 1 for VAS back pain at 3 months and VAS leg pain at 6 months follow‐up. Significantly higher scores in Group 3 compared with Group 1 were also observed in the SF‐36 PCS at 6, 12 and 24 months. Significantly higher scores in Group 2 compared with Group 1 were observed at 6 months follow up. These trends were also observed when investigating the percentage of patients with a greater 50% improvement in the outcome measure. Conclusions Physiotherapy post‐LTDR produces statistically significant and possibly clinically important improvements in functional disability, pain and quality of life outcomes compared with self‐mediated rehabilitation. Copyright © 2015 John Wiley & Sons, Ltd.