ORIGINAL RESEARCHHow Many Steps Per Day During the Early Postoperative Period are Associated With Patient-Reported Outcomes of Disability, Pain, and Opioid Use After Lumbar Spine Surgery?
Section snippets
Study participants
A total of 248 English-speaking adults undergoing lumbar spine surgery were recruited from 2 academic medical centers in the United States. The detailed description of the recruitment of the study participants has previously been published.20 Patients underwent a laminectomy procedure (with or without fusion) for a lumbar degenerative condition, including spondylosis, degenerative spondylolisthesis, and spinal stenosis. Participants were excluded if they were primarily undergoing discectomy or
Results
Of 248 enrolled participants undergoing surgery for a degenerative lumbar spine condition, 212 wore accelerometer for ≥3 valid days, 10 wore it for <3 valid days, and 26 had missing physical activity data (table 1). Comparisons by accelerometer wear status (ie, ≥3 valid days vs <3 valid days or missing) found similar baseline characteristics, except for surgical fusion procedure (69.3% vs 47.2%, P=.01) (see table 1). Participants also had similar outcomes at all time points (table 2), except
Discussion
This study found that taking more steps/day during the early postoperative period was statistically associated with achieving the “best outcome” and no opioid use at 1 year after lumbar spine surgery. Specifically, walking at least 3500 steps/d best discriminated those who achieved these outcomes from those who did not. Our findings support a recommendation for walking early after surgery and provide an evidence-based steps/day threshold that rehabilitation professionals can use during early
Conclusions
Our study findings suggest that taking more steps/day during the early postoperative period may be associated with achieving a “best outcome” in disability and back and leg pain and lower opioid use in patients undergoing lumbar spine surgery. Walking at least 3500 steps/d was found to be an important threshold for achieving these outcomes and provides rehabilitation providers with an initial patient recommendation that can be used during early postoperative management. Given the observational
Suppliers
- a.
GT3X; ActiGraph.
- b.
SPSS, version 25; IBM Inc.
- c.
MedCalc statistical software; MedCalc Software.
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2023, Seminars in Spine SurgeryWorsening pain and quality of life for spine surgery patients during the COVID-19 pandemic: Roles of psychological distress and patient activation
2022, North American Spine Society JournalCitation Excerpt :In the current study, average pain scores for the back and legs worsened significantly, whereas neck and arm pain scores did not change significantly between respondents’ latest clinic visit and the onset of the COVID-19 pandemic. Prior research has demonstrated the link between increased walking during post-operative recovery and higher odds of meaningful improvement in back and leg pain [29]. It is probable that, given pandemic restrictions on non-essential activities, walking and similar activities were curtailed among these patients.
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Presented to the American Physical Therapy Association, February 22, 2021, virtual; North American Spine Society, October 10, 2020, virtual.
Supported by a Patient-Centered Outcomes Research Institute award (award no. CER-1306-01970).
Disclosures: Kristin R. Archer reports personal fees from Pacira outside the submitted work. Jacquelyn S. Pennings reports personal fees from ICZ International Surgical and Steamboat Orthopaedic and Spine Institute. Clinton J. Devin reports personal fees from Wright Medical, Stryker, and Medtronic. Brian J. Neuman reports personal fees from Medtronic and DePuy Synthes. Rogelio A. Coronado was supported by a Vanderbilt Faculty Research Scholars award during manuscript development. The other authors have nothing to disclose. The authors have no personal or institutional financial interest in drugs, materials, or devices described in their submissions.