The effect of pedometer supported walking and telemonitoring after disc hernia surgery on pain, disability levels, and quality of life: study protocol
Background: Surgical intervention is the most common among the methods used to treat LDH, and its success rate is high. Despite this, patients can experience mild to moderate pain and disability after surgery. In the management of this pain and disability, walking forms the first step of rehabilitation and is an easy and long term method. This study was planned to determine the effect of a pedometer supported walking program and telemonitoring after disc hernia surgery on pain, disability levels and quality of life.
Methods: This study was planned as a randomized controlled study. Patients will be randomized into the study and control groups through the closed envelope method. Patients in the study group will receive an intervention through a 12 week walking program and weekly telemonitoring. The pain levels of the patients included in the study will be evaluated using the short form Mcgill pain questionnaire, their disability levels will be evaluated using the Oswestry disability index, and their quality of life will be evaluated using the SF-36. Patients in both the study and control groups will be evaluated with regard to pain and disability levels in the follow ups in the 3rd, 7th, and 11th weeks, and with regard to pain, disability, and quality of life in the 15th week.
Conclusions: Daily regular walks have great importance in the management of mild lower back pain. This study was planned to determine the effect of walking with a pedometer after LDH surgery with weekly monitoring.
Rabini A, Aprile I, Padua L, Piazzini DB, Maggi L, Ferrara PE, et al. Assessment and correlation between clinical patterns, disability and health-related quality of life in patients with low back pain. Eura Medicophys. 2007;43(1):49-54.
Hermenau S, Grauger JN. The evaluation and management of axial neck and low back pain. In: Rao R, Smuck M, editors. Orthopedic Knowledge Update. Spine 4, Chapter 25. Madrid,España: AAOS; 2012: 283–292.
Andersson GB. Epidemiological features of chronic low back pain. Lancet. 1999;354:581–5.
TUİK Turkey Demographic and Health Survey 2016. Available at: www.tuik.gov.tr/PdfGetir. do?id=2457. Accessed on 13 September 2017.
Muslumanoglu L. Back Pain Causes. In:Ozcan E, Ketenci A, eds. Lumbar Pain Diagnosis and Treatment, Nobel Bookstore, İstanbul, 2002: 145-187.
Ozcan Yıldız E. Back Pain. In:Beyazova M, Gokce- Kutsal Y, eds. Physical Medicine and Rehabilitation, Gunes Bookstore, Ankara, 2000: 1465-1483.
Sherman J, Cauthen J, Schoenberg D, Burns M, Reaven NL, Griffith SL. Economic impact of improving outcomes of lumbar discectomy. Spine J. 2010;10(5):108– 16.
Machado GC, Witzleb AJ, Fritsch C, Maher CG, Ferreira PH, Ferreira ML.Patients with sciatica still experience pain and disability 5 years after surgery: asystematic review with meta-analysis of cohort studies. Eur J Pain. 2016;20(10):1700-9.
Thomas KC, Fisher CG, Boyd M, Bishop P, Wing P, Dvorak MF. Outcome evaluation of surgical and nonsurgical management of lumbar discprotrusion causing radiculopathy. Spine 2007;32(13):1414-12.
Hayden JA, van Tulder MW, Malmivaara AV, Koes BW. Meta-analysis:exercise therapy for non specific low back pain. Ann Internal Med. 2005;142 (9):765-75.
Van Tulder MW, Koes B, Malmivaara A. Outcome of non-invasive treatment modalities on backpain:an evidence-based review. Eur Spine J. 2006;15(1):64-81.
Sherman KJ, Cherkin DC, Erro J, Miglioretti DL, Deyo RA. Comparing yoga, exercise, and a self-care book for chronic low back pain: a randomized, controlled trial. Ann Int Med. 2005;143(12):849-856.
Von Korff M, Balderson BH, Saunders K, Miglioretti DL, Lin EH, Berry S, et al. A trial of an activating intervention for chronic back pain in primary care and physicaltherapy settings. Pain. 2005;113(3):323-30.
Mailloux J, Finno M, Rainville J. Long-term exercise adherence in the elderly with chronic low back pain. Am J Physical Med Rehab Assoc Acad Physiatr. 2006;85(2):120-6.
Milosavljevic S, Clay L, Bath B, Trask T, Erika Penz E, Stewart S, et al. Walking away from back pain:one step at a time – a community-based randomised controlled trial. BMC Public Health. 2015;15:144.
Hurley DA, O’Donoghue G, Tully MA, Klaber Moffett J, van Mechelen W, Daly L, et al. A walking programmeand a supervised exercise class versus usual physiotherapy for chronic low backpain:a single blinded randomised controlled trial (The Supervised Walking In comparison to Fitness Training for Back Pain (SWIFT) Trial). BMC Musculoskelet Disord. 2009;10:79.
Krein SL, Abdul-Wahab Y, Kadri R, Richardson CR. Adverse events experienced by participants in a back pain walking intervention:A descriptive study Chronic Illness. 2016;12(1):71–80.
Ryan CG, Grant PM, Dall PM, Gray H, Newton M, Granat M. Individual swith chronic low back pain have a lower level, and an altered pattern of physical activity compared with matched controls:an observational study. Australian J Physiotherap. 2009;55(1):53-58.
Hurley DA, Brady L, O'Brien E, McDonough SM, Baxter GD, Heneghan C. Subjective and objective evaluation of the physical activity profiles of people with low back pain and age matched control sover 7-days. J Bone Joint Surg Br. 2019.
Mobbs JR, Phan K, Maharaj M, Rao P. Physical Activity Measured with Accelerometerand Self-Rated Disability in Lumbar Spine Surgery:A Prospective Study. Global Spine J. 2016;6(5):459-64.
World Health Organization, Chodzko Zaijko WJ. The World Health Organization issues guide lines for promoting physical activity among older persons. Journal of aging and physical activity. 2010;5.
Dahm KT, Brurberg KG, Jamtvedt G, Hagen KB. Adviceto rest in bed versus advice to stay active for acute low-back painand sciatica. Cochrane Database Syst Rev. 2010:6:CD007612.
Glimore S, Mc Clelland J, Davidson M. Does walking after lumbar spinal surgery predict recovery of function at six months? Protocol for a prospective cohort study. BMC Musculoskeletal Disordes. 2016;17:472.
Mansi S, Milosavljevic S, Baxter G, Tumilty S, Hendrick P. A systematic review of studies using pedometers as an intervention for musculoskeletal diseases. BMC Musculoskelet Disord. 2014;15(1):231.
Mc Donough SM, Tully MA, Boyd A, O’Connor SR, Kerr DP, O’Neill SM, et al. Pedometer-driven walking for chronic low back pain:a feasibility randomized controlled trial. Clin J Pain. 2013;29(11):972–81.
Koes BW, vanTulder M, Lin CC, Macedo LG, McAuley J, Maher C. An update döver view of clinical guidelines for the management of non-specific low back pain in primary care. Eur Spine J. 2010;19(12):2075–94.
Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, et al. American College of Sports Medicine. American College of Sports Medicine positionstand. Quantity and quality of exercise ford evelopin gand maintaining cardio respiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exercise. 2011;43(7):1334–59.
Tully MA, Cupples ME, Chan WS, McGlade K, Young IS. Brisk walking, fitness, and cardio vascular risk:a randomized controlled trial in primary care. Prevent Med. 2005;41(2):622-8.
Schulte TL, Schubert T, Winter C, Brandes M, Hackenburg L, Wassmann H, et al. Step activity monitoring in lumbar stenosis patient sunder going decompressive surgery. Eur Spine J. 2010;19(11):1855–64.
Harris T, Kerry SM, Limb ES, Victor CR, Iliffe S, Ussher M, et al. Effect of a Primary Care Walking Intervention with and without Nurse Support on Physical Activity Levels in 45- to 75-Year-Olds:The Pedometer And Consultation Evaluation (PACEUP) Cluster Randomised Clinical Trial. PLoS Med. 2017;14:1.
Torstensen TA, Ljunggren AE, Meen HD, Odland E, Mowinckel P, Geijerstam S. Efficiency and costs of medical exercise therapy, conventional physio therapy and self exercise in patients with chronic low back pain. Spine. 1998;23(23):2616-24.
Bravata DM, Smith-Spangler C, Sundaram V, Gienger AL, Lin N, Lewis R, et al. Using pedometer stoin crease physical activity and improve health:a systematic review. JAMA. 2007;298(19):2296–304.
Yakut Y, Yakut E, Bayar K, Uygur F. Reliabilitiy and validity of the Turkish version Short-From Mcgill Pain Questionnaire in patients with rheumatoid arthritis. Clin Rheumatol. 2007;26:1083-7.
Melzack R. The Short Form Mcgill Pain Questionnaire. Pain. 1987;30 (2):191-7.
Demiral Y, Ergör G, Ünal B, Semin S, Akvardar Y, et al. Normative data and discriminative properties of short form 36 (SF-36) in Turkish urban population. BMC Public Health. 2006;6:247.
Yakut E, Duger T, Oksuz Ç, Yoruksan S, Uretan K, Turan D, et al. Validation of the Turkish version of the Oswesrty Disability Index for patients with low back pain. Spine. 2004;29(5):581-5.