TY - JOUR
T1 - Bouncing back after lumbar spine surgery
T2 - early postoperative resilience is associated with 12-month physical function, pain interference, social participation, and disability
AU - Coronado, Rogelio A.
AU - Robinette, Payton E.
AU - Henry, Abigail L.
AU - Pennings, Jacquelyn S.
AU - Haug, Christine M.
AU - Skolasky, Richard L.
AU - Riley, Lee H.
AU - Neuman, Brian J.
AU - Cheng, Joseph S.
AU - Aaronson, Oran S.
AU - Devin, Clinton J.
AU - Wegener, Stephen T.
AU - Archer, Kristin R.
N1 - Funding Information:
Funding Disclosures: This research was supported by grants from Patient-Centered Outcomes Research Institute ($1,867,629) and the Foundation for Physical Therapy Research ($40,000).
Funding Information:
Author disclosures: RAC: Grant: PCORI; Foundation for Physical Therapy Research. PER: Grant: PCORI; Foundation for Physical Therapy Research. ALH: Grant: PCORI; Foundation for Physical Therapy Research. JSP: Grant: PCORI; Foundation for Physical Therapy Research; Consulting: Steamboat Orthopaedic and Spine Institute, International Surgical SEZC. CMH: Grant: PCORI; Foundation for Physical Therapy Research. RLS: Grant: PCORI; Board of Directors: North American Spine Society (travel reimbursement); Scientific Advisory Board/Other Office: Quality of Life Research, Editorial Board ($1,000). LHR: Grant: PCORI. BJN: Grant: PCORI; Speaking and/or Teaching Arrangements: Medtronic ($10,000); Research Support (Investigator Salary, Staff/Material)^: Depuy Synthes ($25,000). JSC: Trips/Travel: AANS, CNS, AO, NASS (Travel for societies); Board of Directors: CSNS Vice-Chair (No compensation). OSA: Grant: PCORI. CJD: Royalties: Wright Medical; Consulting: Stryker; Medtronic. STW: Grant: PCORI; Royalties: Book Royalties—Springer; Grants: DoD, PCORI, PVH. KRA: Grant: PCORI; Foundation for Physical Therapy Research ($1,867,629 ; $40,000); Consulting: NeuroPoint Alliance, Inc; Consulting: Pacira; Scientific Advisory Board/Other Office: APTA ($1500).
Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2021/1
Y1 - 2021/1
N2 - BACKGROUND CONTEXT: Positive psychosocial factors early after surgery, such as resilience and self-efficacy, may be important characteristics for informing individualized postoperative care. PURPOSE: To examine the association of early postoperative resilience and self-efficacy on 12-month physical function, pain interference, social participation, disability, pain intensity, and physical activity after lumbar spine surgery. STUDY DESIGN/SETTING: Pooled secondary analysis of prospectively collected trial data from two academic medical centers. PATIENT SAMPLE: Two hundred and forty-eight patients who underwent laminectomy with or without fusion for a degenerative lumbar condition. OUTCOME MEASURES: Physical function, pain inference, and social participation (ability to participate in social roles and activities) were measured using the Patient Reported Outcomes Measurement Information System. The Oswestry Disability Index, Numeric Rating Scale, and accelerometer activity counts were used to measure disability, pain intensity, and physical activity, respectively. METHODS: Participants completed validated outcome questionnaires at 6 weeks (baseline) and 12 months after surgery. Baseline positive psychosocial factors included resilience (Brief Resilience Scale) and self-efficacy (Pain Self-Efficacy Questionnaire). Multivariable linear regression analyses were used to assess the associations between early postoperative psychosocial factors and 12-month outcomes adjusting for age, sex, study site, randomized group, fusion status, fear of movement (Tampa Scale for Kinesiophobia), and outcome score at baseline. This study was funded by Patient-Centered Outcomes Research Institute and Foundation for Physical Therapy Research. There are no conflicts of interest. RESULTS: Resilience at 6 weeks after surgery was associated with 12-month physical function (unstandardized beta=1.85 [95% confidence interval [CI]: 0.29; 3.40]), pain interference (unstandardized beta=−1.80 [95% CI: −3.48; −0.12]), social participation (unstandardized beta=2.69 [95% CI: 0.97; 4.41]), and disability (unstandardized beta=−3.03 [95% CI: −6.04; −0.02]). Self-efficacy was associated with 12-month disability (unstandardized beta=−0.21 [95% CI: −0.37; −0.04]. CONCLUSIONS: Postoperative resilience and pain self-efficacy were associated with improved 12-month patient-reported outcomes after spine surgery. Future work should consider how early postoperative screening for positive psychosocial characteristics can enhance risk stratification and targeted rehabilitation management in patients undergoing spine surgery.
AB - BACKGROUND CONTEXT: Positive psychosocial factors early after surgery, such as resilience and self-efficacy, may be important characteristics for informing individualized postoperative care. PURPOSE: To examine the association of early postoperative resilience and self-efficacy on 12-month physical function, pain interference, social participation, disability, pain intensity, and physical activity after lumbar spine surgery. STUDY DESIGN/SETTING: Pooled secondary analysis of prospectively collected trial data from two academic medical centers. PATIENT SAMPLE: Two hundred and forty-eight patients who underwent laminectomy with or without fusion for a degenerative lumbar condition. OUTCOME MEASURES: Physical function, pain inference, and social participation (ability to participate in social roles and activities) were measured using the Patient Reported Outcomes Measurement Information System. The Oswestry Disability Index, Numeric Rating Scale, and accelerometer activity counts were used to measure disability, pain intensity, and physical activity, respectively. METHODS: Participants completed validated outcome questionnaires at 6 weeks (baseline) and 12 months after surgery. Baseline positive psychosocial factors included resilience (Brief Resilience Scale) and self-efficacy (Pain Self-Efficacy Questionnaire). Multivariable linear regression analyses were used to assess the associations between early postoperative psychosocial factors and 12-month outcomes adjusting for age, sex, study site, randomized group, fusion status, fear of movement (Tampa Scale for Kinesiophobia), and outcome score at baseline. This study was funded by Patient-Centered Outcomes Research Institute and Foundation for Physical Therapy Research. There are no conflicts of interest. RESULTS: Resilience at 6 weeks after surgery was associated with 12-month physical function (unstandardized beta=1.85 [95% confidence interval [CI]: 0.29; 3.40]), pain interference (unstandardized beta=−1.80 [95% CI: −3.48; −0.12]), social participation (unstandardized beta=2.69 [95% CI: 0.97; 4.41]), and disability (unstandardized beta=−3.03 [95% CI: −6.04; −0.02]). Self-efficacy was associated with 12-month disability (unstandardized beta=−0.21 [95% CI: −0.37; −0.04]. CONCLUSIONS: Postoperative resilience and pain self-efficacy were associated with improved 12-month patient-reported outcomes after spine surgery. Future work should consider how early postoperative screening for positive psychosocial characteristics can enhance risk stratification and targeted rehabilitation management in patients undergoing spine surgery.
KW - Back pain
KW - Outcomes
KW - Positive psychology
KW - Psychosocial
KW - Resilience
KW - Self efficacy
KW - Spine
UR - http://www.scopus.com/inward/record.url?scp=85089861167&partnerID=8YFLogxK
U2 - 10.1016/j.spinee.2020.07.013
DO - 10.1016/j.spinee.2020.07.013
M3 - Article
C2 - 32736036
AN - SCOPUS:85089861167
SN - 1529-9430
VL - 21
SP - 55
EP - 63
JO - Spine Journal
JF - Spine Journal
IS - 1
ER -