Healthy Physical Activity Levels Below Recommended Thresholds Two Years After Lumbar Spine Surgery


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Abstract

Study Design.Prospective analysis.Objective.To quantify physical activity after lumbar surgery and identify spine-related variables associated with not meeting recommended activity thresholds.Summary of Background Data.National guidelines recommend ≥150 minutes/week of moderate-intensity activity; however, only 52% of the general population meets this threshold. For patients not participating in exercise/sports, ≥1400 kcal/week of energy expenditure, including from walking, is another threshold. Potential spine-related variables associated with not meeting these thresholds after lumbar surgery have not been described.Methods.Clinical data were collected pre- and intraoperatively for 422 patients. Patients were contacted 2.2 years postoperatively to measure several patient-reported outcomes, including physical activity with the Paffenbarger Physical Activity and Exercise Index. The Paffenbarger Physical Activity and Exercise Index encompasses blocks walked, stairs climbed, and exercise/sports. Minutes/week of activity and total kcal/week were calculated and compared to recommended thresholds. Spine-related variables associated with not meeting thresholds were assessed in multivariable analyses.Results.Mean age was 57 years, 55% were men, 80% had degenerative diagnoses, and 63% had multilevel surgery. Only 35% met ≥1400 kcal/week; in multivariable analysis, not meeting this threshold was associated with revision surgery (OR 0.53, CI 0.30–0.95), surgery at ≥3 levels (OR 0.51, CI 0.31–0.84), and more postoperative back pain (OR 0.38, CI 0.24–0.59) (P <0.05 for all variables). Only 26% met ≥150 minutes/week; in multivariable analysis, not meeting this threshold was associated with degenerative diagnoses (OR 0.53, CI 0.31–0.92), subsequent spine surgery (OR 0.17, CI 0.05–0.58), and more postoperative back pain (OR 0.41, CI 0.25–0.67) (P <0.05 for all variables). All multivariable associations persisted after controlling for demographic characteristics.Conclusion.Physical activity is below population norms after lumbar surgery and is associated with spine-related variables. Patients with stable spine conditions should be encouraged to engage in prudent physical activity to decrease their risk of long-term adverse health outcomes due to inactivity.Level of Evidence: 3

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