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Outcome of physiotherapy after surgery for cervical disc disease: a prospective randomised multi-centre trial

Peolsson, Anneli; Oberg, Birgitta; Wibault, Johanna; Dedering, Asa; Zsigmond, Peter; Bernfort, Lars; Kammerlind, Ann-Sofi; Persson, Liselott LU and Lofgren, Hakan (2014) In BMC Musculoskeletal Disorders 15.
Abstract
Background: Many patients with cervical disc disease require leave from work, due to long-lasting, complex symptoms, including chronic pain and reduced levels of physical and psychological function. Surgery on a few segmental levels might be expected to resolve disc-specific pain and reduce neurological deficits, but not the non-specific neck pain and the frequent illness. No study has investigated whether post-surgery physiotherapy might improve the outcome of surgery. The main purpose of this study was to evaluate whether a well-structured rehabilitation programme might add benefit to the customary post-surgical treatment for cervical disc disease, with respect to function, disability, work capability, and cost effectiveness.... (More)
Background: Many patients with cervical disc disease require leave from work, due to long-lasting, complex symptoms, including chronic pain and reduced levels of physical and psychological function. Surgery on a few segmental levels might be expected to resolve disc-specific pain and reduce neurological deficits, but not the non-specific neck pain and the frequent illness. No study has investigated whether post-surgery physiotherapy might improve the outcome of surgery. The main purpose of this study was to evaluate whether a well-structured rehabilitation programme might add benefit to the customary post-surgical treatment for cervical disc disease, with respect to function, disability, work capability, and cost effectiveness. Methods/Design: This study was designed as a prospective, randomised, controlled, multi-centre study. An independent, blinded investigator will compare two alternatives of rehabilitation. We will include 200 patients of working age, with cervical disc disease confirmed by clinical findings and symptoms of cervical nerve root compression. After providing informed consent, study participants will be randomised to one of two alternative physiotherapy regimes; (A) customary treatment (information and advice on a specialist clinic); or (B) customary treatment plus active physiotherapy. Physiotherapy will follow a standardised, structured programme of neck-specific exercises combined with a behavioural approach. All patients will be evaluated both clinically and subjectively (with questionnaires) before surgery and at 6 weeks, 3 months, 6 months, 12 months, and 24 months after surgery. The main outcome variable will be neck-specific disability. Cost-effectiveness will also be calculated. Discussion: We anticipate that the results of this study will provide evidence to support physiotherapeutic rehabilitation applied after surgery for cervical radiculopathy due to cervical disc disease. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Intervertebral disc, Spine, Neck, Rehabilitation, Physical therapy
in
BMC Musculoskeletal Disorders
volume
15
publisher
BioMed Central
external identifiers
  • wos:000334802900002
  • scopus:84893200309
ISSN
1471-2474
DOI
10.1186/1471-2474-15-34
language
English
LU publication?
yes
id
9911f6cc-4ebb-4d62-8069-fdafa109a17a (old id 4495969)
date added to LUP
2014-07-01 07:32:16
date last changed
2017-07-09 04:12:46
@article{9911f6cc-4ebb-4d62-8069-fdafa109a17a,
  abstract     = {Background: Many patients with cervical disc disease require leave from work, due to long-lasting, complex symptoms, including chronic pain and reduced levels of physical and psychological function. Surgery on a few segmental levels might be expected to resolve disc-specific pain and reduce neurological deficits, but not the non-specific neck pain and the frequent illness. No study has investigated whether post-surgery physiotherapy might improve the outcome of surgery. The main purpose of this study was to evaluate whether a well-structured rehabilitation programme might add benefit to the customary post-surgical treatment for cervical disc disease, with respect to function, disability, work capability, and cost effectiveness. Methods/Design: This study was designed as a prospective, randomised, controlled, multi-centre study. An independent, blinded investigator will compare two alternatives of rehabilitation. We will include 200 patients of working age, with cervical disc disease confirmed by clinical findings and symptoms of cervical nerve root compression. After providing informed consent, study participants will be randomised to one of two alternative physiotherapy regimes; (A) customary treatment (information and advice on a specialist clinic); or (B) customary treatment plus active physiotherapy. Physiotherapy will follow a standardised, structured programme of neck-specific exercises combined with a behavioural approach. All patients will be evaluated both clinically and subjectively (with questionnaires) before surgery and at 6 weeks, 3 months, 6 months, 12 months, and 24 months after surgery. The main outcome variable will be neck-specific disability. Cost-effectiveness will also be calculated. Discussion: We anticipate that the results of this study will provide evidence to support physiotherapeutic rehabilitation applied after surgery for cervical radiculopathy due to cervical disc disease.},
  articleno    = {34},
  author       = {Peolsson, Anneli and Oberg, Birgitta and Wibault, Johanna and Dedering, Asa and Zsigmond, Peter and Bernfort, Lars and Kammerlind, Ann-Sofi and Persson, Liselott and Lofgren, Hakan},
  issn         = {1471-2474},
  keyword      = {Intervertebral disc,Spine,Neck,Rehabilitation,Physical therapy},
  language     = {eng},
  publisher    = {BioMed Central},
  series       = {BMC Musculoskeletal Disorders},
  title        = {Outcome of physiotherapy after surgery for cervical disc disease: a prospective randomised multi-centre trial},
  url          = {http://dx.doi.org/10.1186/1471-2474-15-34},
  volume       = {15},
  year         = {2014},
}