Key result
Six-week exercise prehabilitation reduces preoperative leg pain ~30% versus standard care before lumbar spinal surgery.
Why the study?
This study intended to assess the feasibility of conducting a preoperative intervention program in patients with lumbar spinal stenosis and report on piloting the proposed intervention.
Does a 6-week supervised preoperative rehabilitation program improve clinical outcomes and is it feasible in patients awaiting lumbar spinal stenosis surgery?
RCT (n=40)
Single-blind
Computer-generated allocation sequence
No
Does a 6-week supervised preoperative rehabilitation program improve clinical outcomes and is it feasible in patients awaiting lumbar spinal stenosis surgery?
Absolute Event Rate: 5% vs 7.1%
p-value: p=<0.001
A 6-week supervised preoperative exercise program is feasible and safe for patients awaiting lumbar spinal stenosis surgery, showing potential benefits in pain and physical capacity that warrant a full-scale trial.
Supports prehabilitation to ease preoperative pain before lumbar stenosis surgery; extends evidence to spinal populations and justifies larger outcome trials.
Prehabilitation is defined as the process of augmenting functional capacity before surgery in preparation for the postoperative phase. This study intends to assess the feasibility of conducting a preoperative intervention program in patients with lumbar spinal stenosis and to report on the piloting of the proposed intervention. Patients were allocated to a 6-week supervised preoperative rehabilitation program or a control group. The intervention included supervised exercise sessions aimed to improve strength, muscular endurance, and spinal stabilization. Outcomes were measured at baseline, 6 weeks later and again 6 weeks, 3 months and 6 months after surgery. Sixty-five percent of admissible participants agreed to take part in the study, of which 5% dropped out before the end of the intervention period. Eighty-eight percent of potential training sessions were delivered without adverse event. Improvements were seen in favour of the experimental group at the preoperative assessment for active ranges of motion, leg pain intensity, lumbar extensor muscle endurance and walking capacities. Results show that slight modifications to the choice of outcome measures would increase feasibility of the main study. The absence of adverse events coupled with positive changes seen in dependant outcome measures warrant the conduct of a full-scale trial assessing the effectiveness of the intervention.
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Marchand et al. (2019) conducted an RCT in Lumbar spinal stenosis (n=40). Active exercise prehabilitation program vs. Standard hospital preoperative management was evaluated on Leg pain intensity at preoperative assessment (11-point NRS) (p=<0.001). A 6-week active exercise prehabilitation program was feasible, safe, and significantly reduced preoperative leg pain intensity compared to standard care in patients awaiting lumbar spinal stenosis surgery.
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