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Survey of rehabilitation practice for patients undergoing lumbar surgery in the United Kingdom

Mcilroy, S; Reddington, M; Bearne, LM; Thurgood, D; McCarter, A (2025) Survey of rehabilitation practice for patients undergoing lumbar surgery in the United Kingdom. Musculoskeletal Science and Practice, 78. https://doi.org/10.1016/j.msksp.2025.103365
SGUL Authors: Bearne, Lindsay Mary

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Abstract

Purpose: National guidelines recommend rehabilitation for patients undergoing elective lumbar surgery, yet current provision within the UK is unknown. The aim of this study was to determine Physiotherapy practice regarding prehabilitation, peri-operative, and post-operative rehabilitation, for patients undergoing lumbar discectomy, laminectomy, and single-level fusion, within the UK. Methods: Physiotherapists working within the UK were invited to complete a cross-sectional, descriptive online survey. Open and closed-ended questions enquired about aims, content, format, and frequency of rehabilitation. Quantitative data were analysed descriptively, and open-ended responses were analysed narratively. Results: 360 responses were received, revealing varied practices. Routine provision of prehabilitation was low (18%) whereas peri-operative and post-operative rehabilitation was offered more frequently (>60%). Rehabilitation was predominantly delivered in-person, on a one-to-one basis. Prehabilitation focused on educating patients and optimising psychological and physical health, peri-operative rehabilitation focused on safe mobility, and post-operative rehabilitation on improving function. Advice and education were the most common interventions across all rehabilitation phases. Exercise prescription was frequently used within peri-operative and post-operative rehabilitation. Post-operative restrictions were advised by 62% of respondents. The most frequently provided activity restrictions were for lifting, driving, walking, sitting, and back movement, with timeframes varying considerably. Conclusion: This study highlights considerable variation in access to and content of rehabilitation for patients undergoing lumbar surgery in the UK. While some variation may reflect personalised care, it also suggests uncertainty in the evidence base and inconsistent guideline use. Findings support the need for patient-centred pathways, updated UK-specific guidelines, and further research into implementation barriers, the impact of postoperative restrictions, and tailored rehabilitation interventions.

Item Type: Article
Additional Information: /© 2025 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
SGUL Research Institute / Research Centre: Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: Musculoskeletal Science and Practice
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
RTF2006\14Dunhill Medical Trusthttps://doi.org/10.13039/501100000377
URI: https://openaccess.sgul.ac.uk/id/eprint/117615
Publisher's version: https://doi.org/10.1016/j.msksp.2025.103365

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