Preoperative rehabilitation optimization for spinal surgery: a narrative review of assessment, interventions, and feasibility.

IF 1.6 Q3 CLINICAL NEUROLOGY Spine deformity Pub Date : 2024-09-01 Epub Date: 2024-05-24 DOI:10.1007/s43390-024-00893-0
Justin L Reyes, Josephine R Coury, Alexandra Dionne, Roy Miller, Prerana Katiyar, Abigail Smul, Prachi Bakarania, Joseph M Lombardi, Zeeshan M Sardar
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Abstract

Purpose: 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.

Methods: 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.

Conclusions: 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.

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脊柱手术的术前康复优化:对评估、干预措施和可行性的叙述性回顾。
目的:术后物理治疗(PT)是骨科和肌肉骨骼康复的基石,已被证实可提供各种积极的临床益处。然而,评估脊柱手术术前康复的文献却很少。因此,这篇综述文章旨在概述之前发表的关于术前康复计划的疗效及其在脊柱手术中的作用的研究。文章特别强调了术前虚弱评估、体能测试、干预策略、可行性和未来发展方向:我们利用 PubMed、Google Scholar、EMBASE 和 PubMed Central (PMC) 进行了文献综述,并使用了定向检索词。本综述汇编了研究成人脊柱手术术前康复的文章。研究表明,以运动、柔韧性和行为矫正为重点的术前康复计划可显著改善脊柱外科择期手术患者的疼痛程度和功能强度评估。此外,研究还表明,这些计划还可以缩短住院时间、重返工作岗位时间和整体直接医疗支出费用。FRAIL量表等筛查工具可用于评估虚弱程度,而定时起立行走(TUGT)、5次重复坐立测试(5R-STST)和手握力(HGS)等身体功能测试可帮助确定哪些患者最能从康复前训练中获益:本综述表明,康复训练计划有可能提高生活质量、改善身体功能和活动水平,并减少疼痛、住院时间、重返工作岗位时间和整体直接成本。然而,该领域的文献还很少,需要进一步研究和调查。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.20
自引率
18.80%
发文量
167
期刊介绍: Spine Deformity the official journal of the?Scoliosis Research Society is a peer-refereed publication to disseminate knowledge on basic science and clinical research into the?etiology?biomechanics?treatment?methods and outcomes of all types of?spinal deformities. The international members of the Editorial Board provide a worldwide perspective for the journal's area of interest.The?journal?will enhance the mission of the Society which is to foster the optimal care of all patients with?spine?deformities worldwide. Articles published in?Spine Deformity?are Medline indexed in PubMed.? The journal publishes original articles in the form of clinical and basic research. Spine Deformity will only publish studies that have institutional review board (IRB) or similar ethics committee approval for human and animal studies and have strictly observed these guidelines. The minimum follow-up period for follow-up clinical studies is 24 months.
期刊最新文献
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