A review, published ahead of print in The European Spine Journal, has found that patients have a clear desire for specific advice on which exercises to perform to help their recovery from spinal surgery, causing a dilemma for spinal surgeons as there is no evidence to support specific exercise prescription.
Alison McGregor, Surgery and Cancer, Faculty of Medicine, Imperial College, London, UK, and co-authors examined data from two subgroups of the FASTER (Function after spinal treatment, exercise and rehabilitation) study, which assessed the post-operative management of patients following spinal surgery, to review patients’ perceptions of a patient education booklet, “Your Back Operation,” that provided advice on recovering from spinal surgery. The subgroups were patients who received the book by itself and patients who received the booklet plus rehabilitation.
Of the 114 patients who received the booklet and responded to an 11 forced-choice questionnaire about the booklet, the majority (75%) found the content interesting and that they learned “new and helpful” facts (78%). While the majority (69%) also claimed to be content with the booklet, 31% reported that it had “deficiencies”.
A main complaint was that the booklet lacked specific detail on the type, duration, frequency, and intensity of exercises. According to McGregor et al, the booklet focuses on encouraging patients to “getting moving and being active” rather than providing specific advice because there is a lack of evidence about which exercises should be performed to improve recovery after spinal surgery. Therefore, the fact that patients want more detailed information creates a dilemma “in terms of what to include in such a regime” and is “clearly an area for future work” as any advice provided would have to be “safe, clear, and appropriate for a range of patients’ abilities.” However, McGregor et al added that the finding was also “encouraging as it does support the notion that patients want to be active partners in their recovery.”
Other “key areas for revision”, following the questionnaire, were identified as being the need to provide clear recovery milestones, clear discharge information on wound care and dressing changes, and more information on pain control. McGregor et al concluded: “The booklet was welcomed by patients and they valued the information and support it contained. However, clearly not all aspects of care are covered, and in some instances, the messages to return to activity and an active lifestyle were not understood.”
Alison McGregor told Spinal News International about the value of patient education. She said: “We increasingly realise the importance of active patient participation in recovery but without appropriate tools to educate patients fully, we will always struggle to achieve this and perhaps may not realise the real impact some therapies offer due to poor compliance. Whilst such material may not directly influence functional recovery, it does appear to enhance the patient experience—which is equally important.”