Prehabilitation for Lumbar Spinal Stenosis

Recruiting in Palo Alto (17 mi)

+3 other locations

Overseen ByLisa Carlesso, PhD

Age: 18+

Sex: Any

Travel: May be covered

Time Reimbursement: Varies

Trial Phase: Academic

Waitlist Available

Sponsor: McMaster University

No Placebo Group

Trial Summary

What is the purpose of this trial?The literature has shown evidence of the effectiveness of prehabilitation programs on post-operative recovery for musculoskeletal conditions; however, evidence for prehabilitation for lumbar spinal stenosis (LSS) is limited. Investigators have found that there is very low to low quality evidence for the effect of prehabilitation interventions for improving outcomes following lumbar spine surgery. Therefore, the purpose of this study will be to determine the feasibility of a prehabilitation program for patients undergoing LSS surgery, and pilot test the protocol to provide the foundation for future design of a larger, multicenter randomized controlled trial.

Eligibility Criteria

This trial is for individuals over 55 years old who are scheduled for their first spinal surgery due to lumbar spinal stenosis (LSS) and have at least 20 weeks before their operation. Participants must be able to read and understand English without significant visual or hearing impairments, have internet access, and be capable of exercising.

Inclusion Criteria

I am scheduled for my first spinal surgery.

It has been at least 20 weeks since my spine surgery.

I am older than 55.

Exclusion Criteria

I have been diagnosed with a specific condition like cancer.

Participant Groups

The study is testing the feasibility of a 'prehabilitation' program designed to improve recovery after LSS surgery compared with usual care. It aims to establish groundwork for a larger future trial by piloting this pre-surgery exercise protocol.

2Treatment groups

Experimental Treatment

Active Control

Group I: PrehabilitationExperimental Treatment1 Intervention

The 8-week prehabilitation program will be delivered online using synchronous and asynchronous sessions delivered by either a physiotherapist, chiropractor or kinesiologist. There will be 4 individual exercises sessions delivered synchronously using Zoom or Physitrack in which motivational interviewing and graded activity exercises will be conducted. Participants will also be asked to exercise at least 3 times a week using the asynchronous exercise videos. The exercises will be individualized on participants functional ability and personal goals identified at baseline, with a focus on muscle strengthening, stretching, improving spinal flexibility and stability. There will be a booster session at 6-weeks post-op. Participants will also undergo 5 group educational sessions, which will provide information regarding: goal setting, pain education, self-management, pacing, post-operative expectations, exercise recommendations, and information regarding their upcoming surgery.

Group II: Usual CareActive Control1 Intervention

Participants in the control group will receive usual care as per surgeons' current practice. This generally consists of one session with an anesthesiologist, a nurse and access to our online videos.