Study Design: Open label randomised controlled trial with 3, 6, 12 month and 2-3 year follow-up.
Objective. To investigate the effectiveness of a psychomotor therapy focusing on cognition, behaviour and motor relearning compared to exercise therapy applied during the first 3 months after lumbar fusion.
Methods: The study recruited 107 patients, aged 18 to 65 years, selected for lumbar fusion due to 12 months of symptomatic spinal stenosis, degenerative/isthmic spondylolisthesis or degenerative disc disease. The exercise therapy group received a home program focusing on pain contingent training of back, abdominal and leg muscle functional strength and endurance, stretching and cardiovascular fitness. The psychomotor therapy group received a home program and 3 outpatient sessions focusing on modifying maladaptive pain cognitions, behaviours and motor control. Patient-rated questionnaires investigating functional disability, pain, health related quality of life, functional self-efficacy, outcome expectancy, fear of movement/(re)injury and copingwere assessed at baseline, 3, 6, 12 months and 2-3 years after surgery.
Results: Follow-up rates were 93% at 12 months and 81% at 2-3 years after surgery. Psychomotor therapy improved functional disability, self-efficacy, outcome expectancy and fear of movement/(re)injury significantly more than exercise therapy at respective follow-up occasions. Similar results occurred for pain coping but group differences were non-significant at 2-3 year follow-up.
Conclusions: The study shows that post-operative rehabilitation can be effectively implemented during the first 3 months after lumbar fusion and should include measures to modify psychological aswell as motor functions.
2010. 186-186 p.
Seventh SICOT/SIROT Annual International Conference & SOF Ortopediveckan, Gothenburg, Sweden, 31 August – 3 September 2010