Lumbar spine rehabilitation protocols

The goal of my project was twofold:

-1. Give physical therapists guidance regarding rehabilitation of patients who had undergone either lumbar discectomy/laminectomy or a fusion.

Based on a literature review,  MaesK-evidence%20table%20capstone%202015-2 I created a protocol for each patient population.

For lumbar discectomy and laminectomy there is a fair mount of evidence to support the use of physical therapy post-operative.

Lumbar%20discectomy%20protocol

For lumbar fusion the research is more limited as the focus in this mainly elderly population is not on exercise. Interestingly two aspects were included here, hip stability exercises and addressing the psychosocial aspect of fear avoidance behavior.

Lumbar%20fusion%20protocol

I created a powerpoint presentation and presented this at one of our outpatient in-services. The overview explains the actual procedures and post-operative restrictions, reviews proper body mechanics and addresses the appropriate exercises to be implemented post-surgery.

Lumbar spine therapy protocols[1]

I also created a post-presentation questionnaire to evaluate to usefulness of my materials.

MaesK-post-presentation quesionnaire

2. Create a handout for patients. From my interviews with the UNC spine surgeons Lumbar spine protocols survey MD, it became clear that most patients were not sent to physical therapy unless they remained symptomatic post-surgery. The handouts educate the patients on their particular procedure, reminds them of lifting and other restrictions, reviews proper body mechanics and gives them information regarding physical therapy options.

I again made a questionnaire to test the usefulness of the handout. I hope to send these brochures, after review by the surgeons,  through the appropriate channels at UNC so it can be distributed for patients. To ensure I used the appropriate language, I did a health literacy assessment, which indicated that the brochure was written at a 3rd grade reading level.

Patient questionnaire patient brochure capstone fusion

patient brochure capstone discectomy

Patient questionnaire

MaesK_health literacy assessment

Both questionnaires had positive outcomes to where I feel I created some useful tools for UNC therapists and patients.

MaesK evaluation capstone

I hope my work will help both patients and therapists understand the impact of the surgical procedure as well as the rehabilitation process.

Kristel