Anneli Peolsson1, Håkan Löfgren2, Åsa Dedering3,4, Birgitta Öberg1, Peter Zsigmond5, Henrik Hedevik1, Johanna Wibault1,6. 1. 1Department of Medical and Health Sciences, Physiotherapy, Linköping University, Linköping. 2. 2Neuro-Orthopedic Center, Ryhov Hospital, Region Jönköping County, Jönköping. 3. 3Allied Health Professionals Function, Function Area Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm. 4. 4Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm. 5. 5Department of Neurosurgery, Linköping University Hospital, Linköping; and. 6. 6Department of Activity and Health, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
Abstract
OBJECTIVE: Information about postoperative rehabilitation for cervical radiculopathy (CR) is scarce. The aim of this study was to investigate the additional benefits of structured postoperative rehabilitation (SPT), which was performed in all patients, compared with a pragmatic standard postoperative approach (SA), in which rehabilitation was used as needed and patients sought physiotherapy on their own without a referral, in patients with MRI evidence of disc herniation and concomitant clinical signs who underwent surgery for CR. METHODS:Patients (n = 202) were randomized to receive SPT or SA. Included key variables in the present study were primary and selected secondary outcomes of a prospective randomized controlled multicenter study. The main outcome was the Neck Disability Index (NDI) score. The NDI score, pain variables, self-efficacy, and health-related quality of life were investigated at baseline and 3, 6, 12, and 24 months postoperatively. RESULTS:SPT provided no additional benefits over SA (p = 0.08 to p = 0.99) at the postoperative 2-year follow-up. Both groups improved over time (p < 0.0001), with no reported adverse effects. CONCLUSIONS: One can conclude that SPT offered no additional benefits over SA; however, patients tolerated postoperative neck exercises without any negative side effects. These findings are important for the development of future active and neck-specific postoperative rehabilitation interventions for patients with CR.Clinical trial registration no.: NCT01547611 (clinicaltrials.gov).
RCT Entities:
OBJECTIVE: Information about postoperative rehabilitation for cervical radiculopathy (CR) is scarce. The aim of this study was to investigate the additional benefits of structured postoperative rehabilitation (SPT), which was performed in all patients, compared with a pragmatic standard postoperative approach (SA), in which rehabilitation was used as needed and patients sought physiotherapy on their own without a referral, in patients with MRI evidence of disc herniation and concomitant clinical signs who underwent surgery for CR. METHODS:Patients (n = 202) were randomized to receive SPT or SA. Included key variables in the present study were primary and selected secondary outcomes of a prospective randomized controlled multicenter study. The main outcome was the Neck Disability Index (NDI) score. The NDI score, pain variables, self-efficacy, and health-related quality of life were investigated at baseline and 3, 6, 12, and 24 months postoperatively. RESULTS:SPT provided no additional benefits over SA (p = 0.08 to p = 0.99) at the postoperative 2-year follow-up. Both groups improved over time (p < 0.0001), with no reported adverse effects. CONCLUSIONS: One can conclude that SPT offered no additional benefits over SA; however, patients tolerated postoperative neck exercises without any negative side effects. These findings are important for the development of future active and neck-specific postoperative rehabilitation interventions for patients with CR.Clinical trial registration no.: NCT01547611 (clinicaltrials.gov).
Entities:
Keywords:
CR = cervical radiculopathy; NDI = Neck Disability Index; RCT = randomized controlled trial; SA = standard postoperative approach; SES = Self-Efficacy Scale; SPT = structured postoperative rehabilitation; VAS = visual analog scale; cervical radiculopathy; physical therapy modalities; rehabilitation; spine surgery
Authors: Rogelio A Coronado; Carrie E Brintz; Lindsey C McKernan; Hiral Master; Nicole Motzny; Flavio M Silva; Parul M Goyal; Stephen T Wegener; Kristin R Archer Journal: Pain Rep Date: 2020-09-23