Preoperative Physiotherapy versus No Preoperative Conditioning in Lumbar Spine Surgery: A Comparative Study of Pain, Mobility, and Functional Recovery
Vol 06 Issue 1 | January 2025 | page: 07-13 | Birupakshya Mahakul, Narayan Chandra Mahakul
DOI: https://doi.org/10.13107/ojot.2025.v06.i01.64
Received 08/05/2024; Reviewed 02/06/2024; Accepted 19/11/2024; Published 10/01/2025
Authors: Birupakshya Mahakul [1], Narayan Chandra Mahakul [2, 3]
[1] KIMS School of Physiotherapy, KIIT-DU, Bhubaneshwar, Odisha, India.
[2] Regional Spinal Injury Centre (RSIC) Cuttack, Odisha, India.
[3] P.G. Director, Hi- Tech Medical College, Bhubaneshwar, Odisha, India.
Address of Correspondence
Dr. Birupakshya Mahakul
Principal, KIMS School of Physiotherapy, KIIT-DU, Bhubaneshwar.
Email: drbirupakshya@gmail.com
Abstract
Background: Delayed functional recovery and persistent pain following lumbar spine surgery remain significant clinical concerns despite advances in surgical techniques. Preoperative physiotherapy (prehabilitation) has been proposed as a strategy to optimize physical preparedness and accelerate postoperative recovery; however, evidence regarding its effectiveness in lumbar spine surgery remains inconsistent.
Objective: To compare the effects of structured preoperative physiotherapy versus no preoperative conditioning on postoperative pain, mobility, and functional recovery in patients undergoing elective lumbar spine surgery.
Methods: This prospective, randomized comparative study included 120 patients scheduled for elective lumbar spine surgery, who were allocated to either a prehabilitation group (PREHAB, n = 60) or a usual-care control group (NO PREHAB, n = 60). The PREHAB group participated in a six-week supervised physiotherapy program comprising aerobic conditioning, strengthening, lumbar stabilization exercises, flexibility training, and patient education, while the control group received standard preoperative care without structured physiotherapy. Primary outcome was functional disability assessed using the Oswestry Disability Index (ODI) at six weeks postoperatively. Secondary outcomes included pain intensity (Numeric Pain Rating Scale), functional mobility (Timed Up and Go test), functional exercise capacity (Six-Minute Walk Test), length of hospital stay, and postoperative opioid consumption. Outcomes were measured at baseline, preoperatively, and at 2 weeks, 6 weeks, and 3 months postoperatively.
Results: Baseline characteristics were comparable between groups. At six weeks postoperatively, the PREHAB group demonstrated significantly greater improvement in ODI compared with the NO PREHAB group (mean difference −8.5 points; p < 0.001), exceeding the minimal clinically important difference. The PREHAB group also reported significantly lower pain scores at two weeks postoperatively (p < 0.001) and demonstrated superior functional mobility and walking capacity at both six weeks and three months (p < 0.01). Additionally, patients in the PREHAB group had shorter hospital stays and reduced postoperative opioid requirements. No serious adverse events related to preoperative physiotherapy were reported.
Conclusion: Structured preoperative physiotherapy significantly enhances early postoperative recovery following lumbar spine surgery by reducing pain, improving mobility, and accelerating functional restoration. Incorporating prehabilitation into routine preoperative care pathways may represent a safe and effective strategy to optimize surgical outcomes.
Keywords: Preoperative physiotherapy, Prehabilitation, Lumbar spine surgery, Functional recovery, Pain management, Mobility, Rehabilitation
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| How to Cite this Article: Mahakul B, Mahakul NC. Preoperative Physiotherapy versus No Preoperative Conditioning in Lumbar Spine Surgery: A Comparative Study of Pain, Mobility, and Functional Recovery. The Odisha Journal of Orthopaedics and Trauma. January 2025; 06;01:07-13. https://doi.org/10.13107/ojot.2025.v06.i01.64 |
