Spondylolisthesis, Lumbar Region
Conditions
Brief summary
Lumbar arthrodesis is more and more common in general population. Patients need early reeducation after surgery but do not always have access to a physiotherapist. The investigators aim to study the benefits of self-rehabilitation at home after lumbar arthrodesis, showing amelioration in lumbar pain and in quality of life for concerned patients. For this, the investigators designed a randomized-controlled study to test if self-rehabilitation at home right after surgery is superior than rehabilitation done by a physiotherapist 4 to 6 weeks after surgery (standard treatment for our patients).
Detailed description
Due to population aging, lumbar arthrodesis is becoming more frequent in general population. At the same time, those patients need early rehabilitation, even if they do not experiment any motor disability after surgery : it has been showed that early rehabilitation improves lumbar pain thanks to muscle strengthening. The design of the study is prospective,monocentric, controlled and randomized. This study compares progressive self-rehabilitation at home after lumbar arthrodesis, explained to the patient by a physiotherapist during his or her stay at the hospital and started right after surgery, versus rehabilitation done by a physiotherapist 4 to 6 weeks after surgery (standard treatment). The primary outcome is decrease of lumbar pain at 6 weeks and 3 months after surgery. The secondary outcomes are improvement of functional abilities and improvement of pelvis and limbs ranges of motion. Patients of both groups will be followed by surgeon and physiotherapist at 6 weeks and 3 months.
Interventions
OTHERSelf rehabilitation at home
6 week program of exercise at home of gradual intensity and duration
Sponsors
Assistance Publique - Hôpitaux de Paris
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Lumbar pain and/or nerve root pain and/or limp without any motor deficiency of the limbs, before and/or after surgery (if any motor deficiency occurs after surgery, it will be a secondary
Exclusion criteria
) * Surgery for posterolateral lumbar arthrodesis, from a degenerative etiology, from 1 to 3 lumbar levels (one level means one inter-somatic space) * Surgery indication after optimal medical treatment, including appropriate pain medicine, and fail of medical treatment for reducing lumbar pain and/or nerve root pain and/or limp * Return home possible after surgery * After signing consent during pre-operative visit with the surgeon
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change of lumbar pain | At 6 weeks and 3 months after surgery | Improvement of Short Form 36 score (SF-36) Unit : number of points Each item is graded on a scale of 0 to 100, with 0 and 100 serving as the lowest and highest possible scores. A higher number indicates that the subject is in better overall health. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Improvement of functional abilities | At 6 weeks and 3 months after surgery | Improvement of Oswestry Disability Index (ODI) Unit : number of points The ODI consists of 10 patient-completed questions in which the response options are presented as 6-point Likert scales. Scores range from 0% (no disability) to 100% (most severe disability). |
| Improvement of ranges of motion - Ely test | At 6 weeks and 3 months after surgery | Improvement of Ely test Angular unit : degree ( ° ) |
| Improvement of ranges of motion - Straight Leg Test | At 6 weeks and 3 months after surgery | Improvement of Straight Leg Test Angular unit : degree ( ° ) |
| Improvement of ranges of motion - Schober test | At 6 weeks and 3 months after surgery | Improvement of Schober test angular unit : degree ( ° ) |
Countries
France
Contacts
Primary ContactBreno MELO, PhD
Backup ContactYoucef Sekour
Outcome results
None listed