Safety and feasibility of an early telephone-supported home exercise program after anterior cervical discectomy and fusion: a case series. (3rd October 2021)

• Record Type: Journal Article
• Authors: Coronado, Rogelio A.; Devin, Clinton J.; Pennings, Jacquelyn S.; Aaronson, Oran S.; Haug, Christine M.; Van Hoy, Erin E.; Vanston, Susan W.; Archer, Kristin R.
• Is Part Of: Physiotherapy theory and practice. Volume 37:Number 10(2021)
• Page Start: 1096
• Page End: 1108
• Publication Date: 2021-10-03
• Subjects: Spinal fusion -- surgical decompression -- neck pain -- Radiculopathy -- exercise therapy -- feasibility studies; Physical therapy -- Periodicals; 615.82
• DOI: 10.1080/09593985.2019.1683921
• Languages: English
• ISSNs: 0959-3985

Abstract

ABSTRACT: Objective : To describe the safety, feasibility, and preliminary outcomes of an early telephone-supported home exercise program (HEP) performed within the first 6 weeks after anterior cervical discectomy and fusion (ACDF) surgery. Methods : Eight patients (mean ± SD age = 53.4 ± 14.9 years, 5 females) were enrolled in this case series. Immediately after surgery, patients began a 6-week HEP including daily walking, deep breathing, distraction techniques, and cervical and upper body exercises. The HEP was supported by weekly telephone calls by a physical therapist. Safety for performing early exercise was examined with radiographic imaging at 6 months. Adverse events were assessed through weekly calls with a physical therapist. HEP adherence and acceptability data were obtained by patient self-report. Clinical measures were assessed preoperatively, at 6 weeks and at 6 months, and included the Neck Disability Index, Numeric Rating Scale for pain, Tampa Scale of Kinesiophobia, Pain Catastrophizing Scale, Pain Self-Efficacy Questionnaire, and accelerometry for physical activity. Results : Early radiographic imaging showed no signs of nonunion at 6 months. There were no reports of serious adverse events. At 6 months, all patients reported clinically significant changes in pain catastrophizing. Seven (88%) patients had clinically significant changes in disability and arm pain, six (75%) patients for neck pain and pain self-efficacy, and five (53%) patients for fear of movement. Only three (43%) of seven patients showed increased physical activity at 6 months. Conclusion : Based on this small case series, an early telephone-supported HEP appears safe for patients, feasible to implement, and promising for clinical benefits.