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

H. Lotzke*, A. Gutke, M. den Hollander, R. Smeets, M. Lundberg

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

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).
Original languageEnglish
Pages (from-to)51-61
Number of pages11
JournalEuropean Journal of Physiotherapy
Volume22
Issue number1
DOIs
Publication statusPublished - 2 Jan 2020

Keywords

  • chronic low back pain
  • chronic musculoskeletal pain
  • cognitive behavioural approach
  • disability
  • exposure in-vivo
  • fear-avoidance
  • intervention
  • kinesiophobia
  • low-back-pain
  • person-centred
  • physical activity
  • physiotherapy
  • prehabilitation
  • prevention
  • quality
  • reduction
  • spinal fusion surgery
  • QUALITY
  • CHRONIC MUSCULOSKELETAL PAIN
  • DISABILITY
  • INTERVENTION
  • LOW-BACK-PAIN
  • PREVENTION
  • KINESIOPHOBIA
  • REDUCTION
  • Prehabilitation
  • FEAR-AVOIDANCE
  • EXPOSURE IN-VIVO

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