Dear Colleagues,
As a chiropractor dedicated to evidence-based care, I’m excited to share key findings from a recent randomized clinical trial published in Scientific Reports (Marchand et al., 2021) on the effectiveness of exercise-based prehabilitation for patients awaiting surgery for lumbar spinal stenosis (LSS). This study offers valuable insights for our shared goal of optimizing patient outcomes.
Study Overview:
Objective: Evaluate the impact of a 6-week supervised exercise-based prehabilitation program versus usual care on clinical status, physical capacities, and postoperative recovery in patients awaiting LSS surgery.
Participants: 68 patients with LSS were randomized into an intervention group (exercise program) or a control group (usual care).
Intervention: The exercise program included supervised exercises targeting strength, endurance, and mobility, delivered pre-surgery.
Outcome Measures: Pain intensity, LSS-related disability (Oswestry Disability Index), lumbar strength, back extensor endurance, walking capacity, and sit-to-stand performance, assessed post-intervention and at 6 weeks, 3 months, and 6 months post-surgery.
Key Findings:
Pre-Surgery Benefits: The exercise group showed statistically significant improvements at the post-intervention assessment (before surgery) in:
Reduced pain intensity (numerical rating scale for leg and back pain).
Decreased LSS-related disability (Oswestry Disability Index).
Enhanced lumbar flexion strength, back extensor endurance, total ambulation time, and sit-to-stand performance.
Post-Surgery Outcomes: No significant short-term postoperative recovery differences were observed at 6 weeks. However, the exercise group showed a significant reduction in low back-related disability starting at 3 months post-surgery, sustained at 6 months.
Safety: No adverse events were reported, indicating the program’s safety for LSS patients.
Conclusion: Exercise-based prehabilitation provides small but significant pre-surgical improvements in pain, disability, and physical function for LSS patients but does not enhance short-term postoperative recovery. Long-term benefits in disability reduction are notable by 3 months post-surgery.
Clinical Implications: This study supports the integration of supervised exercise programs into pre-surgical care for LSS patients. Prehabilitation can enhance patients’ physical function and reduce disability before surgery, potentially improving their readiness for surgical intervention and long-term outcomes. As chiropractors, we are uniquely positioned to deliver such evidence-based interventions, collaborating with medical teams to optimize patient care.
How We Can Collaborate: At Kissimmee Family Wellness Center, we are committed to evidence-based, proactive care. Our chiropractic services include tailored exercise programs, manual therapies, and patient education, all grounded in research like this study. We welcome opportunities to partner with you to support your LSS patients through prehabilitation, enhancing their pre-surgical function and long-term recovery. Please contact me to discuss referrals or co-management strategies.
Source: Marchand, A.-A., et al. (2021). Effectiveness of an exercise-based prehabilitation program for patients awaiting surgery for lumbar spinal stenosis: a randomized clinical trial. Scientific Reports, 11(1), 11080. https://pubmed.ncbi.nlm.nih.gov/34040109/
Contact:
Bryon Moore, DC
Kissimmee Family Wellness Center
(407) 847-4101
drbmoore@kfwc.com
Sincerely,
Bryon Moore, DC
