title: Physiotherapeutic Rehabilitation Following Lumbar Total Disc Replacement: A Retrospective Study.
abstract: OBJECTIVE
  This study sought to answer the following questions: What are the outcomes of physiotherapy post lumbar total disc replacement (LTDR) compared with patient self-mediated rehabilitation? Is a difference in outcomes related to the number of physiotherapy sessions?
  
  
  METHODS
  This is a retrospective observational study of 600 patients post TDR. Patient outcomes for self-mediated rehabilitation (Group 1), 1-3 sessions of clinic-based physiotherapy (Group 2) and ≥4 sessions of clinic-based physiotherapy (Group 3) were analysed. Outcomes measures included the Oswestry Disability Index (ODI), Roland Morris Disability Questionnaire (RMQ), Short Form-36 Physical (SF-36 PCS) and Mental Subscale Components (SF-36 MCS), Visual Analogue Scale (VAS) for back and leg pain intensity. Patient's pre-operative baseline measures and post-operative follow-up measures at 3, 6, 12 and 24 months post-operatively were analysed.
  
  
  RESULTS
  Oswestry Disability Index and RMQ had significantly lower scores in Group 3 compared with Group 1 at 3, 6, 12 and 24 months follow-up. Significantly lower scores for Group 2 compared with Group 1 were observed for the ODI at 3 months follow-up and for the RMQ at 3 and 6 months follow-up. Significantly lower scores were observed in Group 3 compared with Group 1 for VAS back pain at 3 months and VAS leg pain at 6 months follow-up. Significantly higher scores in Group 3 compared with Group 1 were also observed in the SF-36 PCS at 6, 12 and 24 months. Significantly higher scores in Group 2 compared with Group 1 were observed at 6 months follow up. These trends were also observed when investigating the percentage of patients with a greater 50% improvement in the outcome measure.
  
  
  CONCLUSIONS
  Physiotherapy post-LTDR produces statistically significant and possibly clinically important improvements in functional disability, pain and quality of life outcomes compared with self-mediated rehabilitation. Copyright © 2015 John Wiley & Sons, Ltd.
authors.affiliation: Faculty of Health Science and Medicine, Bond University, Queensland, Australia.|Physiomax, Gold Coast, Australia.
authors.forename: Adeline
authors.initials: A
authors.lastname: Green
authors.affiliation: Faculty of Health Science and Medicine, Bond University, Queensland, Australia.|Physiomax, Gold Coast, Australia.
authors.forename: Philippa
authors.initials: P
authors.lastname: Gilbert
authors.affiliation: Gold Coast Spine, Gold Coast, Australia.
authors.forename: Matthew
authors.initials: M
authors.lastname: Scott-Young
authors.affiliation: Faculty of Health Science and Medicine, Bond University, Queensland, Australia.|Department of Physiotherapy, Karolinska University Hospital, Stockholm, Sweden.|Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
authors.forename: Allan
authors.initials: A
authors.lastname: Abbott
mesh_terms: D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000175:diagnosis / Q000534:rehabilitation* / Q000601:surgery*; D008159:Lumbar Vertebrae; D008297:Male; D010147:Pain Measurement; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D026741:Physical Therapy Modalities / Q000458:organization & administration*; D011182:Postoperative Care / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013548:Sweden; D013997:Time Factors; D059145:Total Disc Replacement / Q000379:methods / Q000534:rehabilitation*; D016896:Treatment Outcome
keywords: orthopaedics; outcome measures; physiotherapy; spinal surgery