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Developing an evidence-based prehabilitation programme designed to improve functional outcomes after lumbar fusion surgery-A feasibility study using the Medical Research Council framework

Artikel i vetenskaplig tidskrift
Författare Hanna Lotzke
Annelie Gutke
M. den Hollander
R. Smeets
Mari Lundberg
Publicerad i European Journal of Physiotherapy
Volym 22
Nummer/häfte 1
Sidor 51-61
ISSN 2167-9169
Publiceringsår 2020
Publicerad vid Institutionen för neurovetenskap och fysiologi, sektionen för hälsa och rehabilitering
Institutionen för kliniska vetenskaper, Avdelningen för ortopedi
Sidor 51-61
Språk en
Länkar dx.doi.org/10.1080/21679169.2018.15...
Ämnesord Prehabilitation, spinal fusion surgery, physiotherapy, cognitive, behavioural approach, person-centred, chronic low back pain, physical, activity, low-back-pain, exposure in-vivo, chronic musculoskeletal pain, fear-avoidance, disability, kinesiophobia, intervention, prevention, reduction, quality, Rehabilitation
Ämneskategorier Sjukgymnastik

Sammanfattning

Purpose: A prehabilitation phase is suggested as the ideal way to prepare patients for optimal outcomes from surgery. Our aim was to describe the lessons we learned from developing PREPARE, an evidence-based prehabilitation programme based on a cognitive behavioural approach designed to improve functional outcomes after lumbar fusion surgery. Methods: We used the Medical Research Council (MRC) framework approach for developing and designing a complex intervention, specifically the two phases; 'Development' and 'Feasibility and Piloting'. Various aspects of treatment fidelity were evaluated during the phase 'Feasibility and Piloting'. As part of the feasibility element, a pilot Single Subject Research Design study was performed. Eleven patients awaiting lumbar fusion surgery participated in the study. We evaluated in particular the use and application of outcome measures. Results: Significant lessons were learned which we used to adjust the prehabilitation programme to better fit a surgical context. The original treatment manual was elaborated on, the outcome measures adjusted, and the content of the intervention altered. Finally, the PREPARE programme was published in the form of a study protocol. Conclusions: There are significant lessons to be learned from testing a study protocol before it is implemented in a large-scale randomised controlled trial (RCT).

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