Exploring Associations of Preoperative Physical Performance With Postoperative Outcomes After Lumbar Spinal Fusion: A Machine Learning Approach

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Abstract

Objective: To explore the association between preoperative physical performance with short- and long-term postoperative outcomes in patients undergoing lumbar spinal fusion (LSF).

Design: Retrospective cohort.

Setting: University hospital.

Participants: Seventy-seven patients (N=77) undergoing elective LSF were preoperatively screened on patient demographics, patient-reported outcome measures, and physical performance measures (movement control, back muscle endurance strength and extensor strength, aerobic capacity, flexibility).

Interventions: Not applicable.

Main Outcome Measures: Associations between preoperative variables and inpatient functional recovery, hospital length of stay (LOS), and 1- to 2-year postoperative pain reduction were explored using random forest analyses assessing the relative influence of the variable on the outcome.

Results: Aerobic capacity was associated with fast functional recovery 5 days (median z scores=7.1 and 12.0). Flexibility (median z score=4.3) and back muscle endurance strength (median z score=7.8) were associated with fast functional recovery 5 days (median z score=8.6). Flexibility (median z score=5.1) and back muscle endurance strength (median z score=13.5) were associated with short LOS 7 days. Maximum back extensor strength (median z score=3.8) was associated with 1- to 2-year postoperative pain reduction and aerobic capacity (median z score=2.8) was tentative.

Conclusions: Physical performance measures were associated with both short- and long-term outcomes after LSF. Adding these measures to prediction models predicting outcomes after LSF may increase their accuracy. (C) 2021 The American Congress of Rehabilitation Medicine. Published by Elsevier Inc.

Original languageEnglish
Pages (from-to)1324-+
Number of pages10
JournalArchives of Physical Medicine and Rehabilitation
Volume102
Issue number7
DOIs
Publication statusPublished - Jul 2021

Keywords

  • Cardiorespiratory fitness
  • Decision support techniques
  • Lumbar vertebrae
  • Muscle strength
  • Physical fitness
  • Rehabilitation
  • LENGTH-OF-STAY
  • SORENSEN TEST
  • PAIN
  • RELIABILITY
  • VALIDITY
  • SURGERY
  • RESPONSIVENESS
  • MOTION
  • RANGE
  • CARE

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