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A Critical Analysis of the Exercise Prescription and Return to Activity Advice That Is Provided in Patient Information Leaflets Following Lumbar Spine Surgery

1
Therapy Outpatient Department, The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust, Bournemouth BH7 7DW, UK
2
Orthopaedic Research Institute, Bournemouth University, Bournemouth BH8 8EB, UK
*
Author to whom correspondence should be addressed.
Medicina 2019, 55(7), 347; https://doi.org/10.3390/medicina55070347
Received: 9 May 2019 / Accepted: 4 July 2019 / Published: 7 July 2019
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Abstract

Background and objectives: Lumbar spine surgery may be considered if pharmacologic, rehabilitation and interventional approaches cannot provide sufficient recovery from low back-related pain. Postoperative physiotherapy treatment in England is often accompanied by patient information leaflets, which contain important rehabilitation advice. However, in order to be an effective instrument for patients, the information provided in these leaflets must be up to date and based on the best available evidence and clinical practice. This study aims to critically analyse the current postoperative aspects of rehabilitation (exercise prescription and return to normal activity) that are provided in patient information leaflets in England as part of an evaluation of current practice following lumbar spine surgery. Materials and Methods: Patient information leaflets from English National Health Service (NHS) hospitals performing lumbar spine surgery were sourced online. A content analysis was conducted to collect data on postoperative exercise prescription and return to normal activities. Results: Thirty-two patient information leaflets on lumbar surgery were sourced (fusion, n = 11; decompression, n = 15; all lumbar procedures, n = 6). Many of the exercises prescribed within the leaflets were not based on evidence of clinical best practice and lacked a relationship to functional activity. Return to normal activity advice was also wide ranging, with considerable variation in the recommendations and definitions provided. Conclusions: This study highlights a clear variation in the recommendations of exercise prescription, dosage and returning to normal activities following lumbar spine surgery. Future work should focus on providing a consistent and patient-centred approach to recovery. View Full-Text
Keywords: patient education; patient information leaflets; lumbar spine surgery; enhanced recovery after surgery (ERAS); rehabilitation; activities of daily living (ADL) patient education; patient information leaflets; lumbar spine surgery; enhanced recovery after surgery (ERAS); rehabilitation; activities of daily living (ADL)
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Low, M.; Burgess, L.C.; Wainwright, T.W. A Critical Analysis of the Exercise Prescription and Return to Activity Advice That Is Provided in Patient Information Leaflets Following Lumbar Spine Surgery. Medicina 2019, 55, 347.

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