ReviewAge and ageing2025
Prehabilitation for lumbar spinal stenosis: understanding mechanisms and contexts for enhanced engagement-a realist review.
Review in Age and ageing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The effectiveness of prehabilitation on post-operative recovery from lumbar spinal stenosis surgery - A systematic review and intervention component analysis.Clinical rehabilitation · 2026Pooled it
- Associations Between Paraspinal Muscle Degeneration, Trunk Isokinetic Strengths, and Spinopelvic Alignment in Patients Undergoing Lumbar Fusion: A Cross-Sectional Study.Journal of clinical medicine · 2026Article
- Searching smarter, not harder: leveraging AI to enhance literature searches for theory-driven reviews-A methodological case study.BMC medical research methodology · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
backgroundNeurogenic claudication (NC) due to lumbar spinal stenosis is the most common reason for spinal surgery in older adults. Prehabilitation may improve outcomes and reduce costs, but current evidence is conflicting. It remains unclear who benefits most, which mechanisms optimise outcomes and what outcomes matter to patients. This review aimed to develop a programme theory explaining what works, for whom, how and in what contexts for prehabilitation of NC surgical candidates.
methodsAn initial programme theory, comprising context-mechanism-outcome configurations (CMOCs), was developed through iterative mapping and consultation with experts (n = 6) and patients (n = 7). This theory was refined via two systematic literature searches and further stakeholder feedback. Studies were assessed for relevance, richness and rigour. Data were holistically coded using abductive and retroductive reasoning to create causal maps, which informed CMOC refinement.
resultsFrom 1422 records, 67 papers were included. The final programme theory included 14 CMOCs focused on patient engagement, a priority identified through patient consultation. Engagement was contingent on clear, consistent communication and addressing misconceptions among both patients and professionals. A shared understanding increased perceived value and avoided missed opportunities for preparation. Personalisation and collaborative goal-setting enhanced ownership and motivation. Ongoing support-via healthcare professional contact and peer input-helped counteract anxiety and feelings of abandonment during the surgical wait.
conclusionsEngagement with prehabilitation for NC can be improved through clear communication, tailored interventions and sustained support. Further research is needed to test whether theory-informed programmes improve outcomes in this population.
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Registered trials
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.