Authors (including presenting author) :
Cheung CFM(1), Kong SB (1), Ku WNH (1), Kwok ML (1)
Affiliation :
(1) Occupational Therapy Department, Yan Chai Hospital
Introduction :
Lumbar spinal fusion is one of the common surgical interventions when conservative treatments fail. The Enhanced Recovery After Surgery (ERAS) program has demonstrated positive outcomes in reducing hospital stays and complications in various surgical procedures. Pre-operative education prior to spinal surgery in the ERAS program is recommended to increase patients’ readiness and minimize discomfort and complications. Although research on the specific effects of preoperative education and occupational therapy prehabilitation was limited, this study suggested potential benefits in terms of reducing hospital stays and improving functional outcomes.
Objectives :
The study aims to evaluate the effectiveness of Occupational Therapy pre-operative education on length of stay, pain level, functional outcomes, Activities of Daily Living (ADL) performance and well-being of patients after lumbar spinal fusion in the ERAS program. The results may provide insight in developing service guideline for patients undergone lumbar spinal fusion.
Methodology :
The research was a retrospective study that recruited patients who enrolled in the ERAS program and underwent lumbar spinal fusion at Yan Chai Hospital (YCH) between 2022 and 2023. The intervention group participated a one-hour session of Occupational Therapy pre-operative education in the out-patient clinic 4-6 weeks prior to the operation. The control group comprised historical control who received routine Occupational Therapy assessment and training in 2022. Data was assessed at pre-operation, 6 weeks post-operation, and 3 months post-operation. The primary outcomes included length of stay (LOS) in hospital, Oswestry Disability Index (ODI), and pain level. The secondary outcomes measured the ADL performance by the Modified Barthel Index (MBI) and well-being of the patients.
Result & Outcome :
A statistically significant difference in length of stay between the education group and control group (p = 0.048) was found. Patients who attended pre-operative education session had an average LOS of 11.95 days, approximately 4 days shorter than that in the control group with 16.03 days. This difference remained significant when analyzing subjects without home medication (p = 0.042). No significant difference was noted in ODI score, pain level, MBI and WHO-5 score between the two groups (p > 0.05). But both groups also showed significant improvement in the above outcome measures at 6 weeks and 3 months post-operation.
