Physiotherapy management of patients undergoing lumbar spinal surgery: A survey of Australian physiotherapists

Abstract

Physiotherapists are commonly involved in the management of patients immediately before and after spinal surgery, however there is currently little known about what constitutes physiotherapy intervention in the hospital setting. This research aimed to describe the current physiotherapy practice in Australia for the peri-operative management of adults undergoing lumbar spinal surgery. A telephone survey was conducted using a structured questionnaire format. All Australian hospitals that admit one or more patients per week for lumbar spinal surgery were invited to take part in the survey. Sixty-four interviews were conducted (response rate 79%). All participating hospitals provided a physiotherapy service for patients undergoing lumbar spinal surgery, with the majority commencing the day following surgery. Physiotherapy intervention consistently included mobility and functional task training, exercise prescription and provision of an educational handout. However, there was considerable variability in the type of exercises prescribed, the advice given regarding post-operative movement and activity restrictions, the use of outcome measurement tools, and referral to inpatient and outpatient physiotherapy services. This survey provides physiotherapists and rehabilitation service providers with information regarding current clinical practice, and identifies the key focus areas for future research into the effectiveness of specific physiotherapy interventions.