Evidence map›Paper›PMID 30788599›Full record

Trial reportEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2019

Rehabilitation following lumbar fusion surgery (REFS) a randomised controlled feasibility study.

James Greenwood, Alison McGregor, Fiona Jones, Michael Hurley

Open access · hybridAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 2 pooled it
1.8field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 19 citations in OpenAlex.

  1. Pooled it
  2. Rehabilitation to improve outcomes of lumbar fusion surgery: a systematic review with meta-analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2022
    Pooled it
  3. Trial
  4. Article
  5. Article
  6. Article
  7. Article
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  10. The Michel Benoist and Robert Mulholland yearly European spine journal review: a survey of the "surgical and research" articles in European spine journal, 2019.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2020
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 1 country.

James GreenwoodVictor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Internal Box 8, Queen Square, London, WC1 3BG, UK. james.greenwood4@nhs.net.ORCID 0000-0003-3323-7699
Alison McGregorBiodynamics Lab, Charing Cross Hospital, Imperial College London, Charing Cross Campus, London, UK.
Fiona JonesFaculty of Health and Social Care Sciences, St Georges University of London, London, UK.
Michael HurleyFaculty of Health and Social Care Sciences, St Georges University of London, London, UK.
St George's, University of London · GBCharing Cross Hospital · GBNational Hospital for Neurology and Neurosurgery · GB

Funding

Department of Health CDRF-2013-04-015National Institute for Health Research CDRF-2013-04-015
6 · The paper itself

Abstract

purposeFollowing lumbar fusion surgery (LFS), 40% of patients are unsure/dissatisfied with their outcome. A prospective, single-centre, randomised, controlled trial was conducted to evaluate the feasibility (including clinical and economic impact) of a theoretically informed rehabilitation programme following LFS (REFS).

methodsREFS was informed by an explicit theoretical framework and consisted of 10 consecutive weekly group rehabilitation sessions (education, low-tech cardiovascular, limb and spine strengthening exercises, and peer support). Participants were randomised to REFS or 'usual care.' Primary feasibility outcomes included recruitment and engagement. Secondary outcomes, collected preoperatively and 3, 6, and 12  months postoperatively, comprised the Oswestry disability index, European Quality of Life 5 dimensions score, pain self-efficacy questionnaire, hospital anxiety and depression scale and the aggregated functional performance time. Economic impact was evaluated with the Client Services Receipt Inventory.

resultsFifty-two of 58 eligible participants were recruited, and engagement with REFS was > 95%. REFS participants achieved a clinically meaningful reduction in unadjusted mean short-term disability (- 13.27 ± 13.46), which was not observed in the 'usual care' group (- 2.42 ± 12.33). This was maintained in the longer term (- 14.72% ± 13.34 vs - 7.57 ± 13.91). Multilevel regression analyses, adjusted for body mass index, baseline depression, and smoking status reported a statistically significant short-term improvement in disability (p = 0.014) and pain self-efficacy (p = 0.007). REFS costs £275 per participant.

conclusionsResults suggest that REFS is feasible and potentially affordable for delivery in the National Health Service. It is associated with a clinically meaningful impact. A multicentre randomised controlled study to further elucidate these results is warranted. These slides can be retrieved under Electronic Supplementary Material.

Indexed as

Spinal DiseasesAdultAgedCost-Benefit AnalysisExercise TherapyFeasibility StudiesFemaleHumansLow Back PainLumbar VertebraeMaleMiddle AgedPatient Education as TopicPostoperative CareProspective StudiesQuality of LifeLumbar fusion surgeryPhysiotherapyRehabilitationTheoretical modelling

Identifiers

PMID30788599
OpenAlexW2916821197

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.