Perioperative rehabilitation

What is the role of rehabilitation following surgery for DCM? Can structured postoperative rehabilitation improve outcome following surgery for DCM? What are the most effective strategies?

Podcast Episode 6: Perioperative rehabilitation

Episode 6 of the AO Spine RECODE-DCM podcast series dives into rehab details, when Benjamin Davies and Michelle Franklin Starkey talk with Tim Boerger, Julio Furlan, and Armin Curt. What is the role of rehabilitation in Degenerative Cervical Myelopathy, pre- and post-surgery? Why do so few people with DCM receive rehabilitation after surgery? Could it make a difference?

Current evidence and reason for uncertainties

A systematic review on the role of postoperative physiotherapy concluded there was insufficient evidence to make any recommendations. No other systematic reviews, scoping reviews or guidelines were identified.

 

Systematic reviews that need updating or extending

Badran A, Davies BM, Bailey HM, Kalsi-Ryan S, Kotter MR. Is there a role for postoperative physiotherapy in degenerative cervical myelopathy? A systematic review. Clin Rehabil. 2018 Sep;32(9):1169-1174.

Source of uncertainty

  • Spinal surgeons

    13

  • Other healthcare professionals

    10

  • People with DCM and their supporters

    4

  • Original suggestions*

    * This list shows the original survey submission(s) that informed the indicative uncertainties and the resulting priority question.

    Does a structured post surgical rehabilitation plan improve outcomes?

    What treatments are recommended to improve post surgery recovery and rehabilitation?

    What are the most effective physical modalities ad exercise programs in management of DCM after surgical treatment?

    Benefits of physical therapy or manipulative therapy post decompression

    Should there be a post-operative rehabilitation programme for people with myelopathy? 

    Best post-operative rehab

    Patients who have surgery, can they benefit from greater involvement in rehab and care provision post operatively.

    What is the optimum post-operative rehabilitation protocol, specifically targeting neurological function (including intensity of practice, therapy modalities) in improving outcomes for people with DCM following surgery?  A qualitative study on the experiences and journeys of people with DCM through the rehabilitation services.

    Can physiotherapy improve function after surgical intervention?  

    Does a combined approach of surgery and Physiotherapy lead to improved outcomes?

    Please more post surgery insight / treatment.   

    How long should be the effective rheabilitation period after surgery DCM ?

    Has intensive rehabilitation in post-operative DCM patient have any additional benefit?

    Are patients having physiotherapy following surgery?

    Benefit & role of rehab following treatment?

    Post surgery rehabilitation 

    What is the role of physical therapy in initiating, preserving neurological recovery after surgery for DCM

    Which patients benefit from postoperative rehabilitation?

    1. What is the role of physiotherapy in DCM (PPOSTOP)?  

    What is the optimum rehabilitation programme (frequency and length) for patients with DCM post operatively?  

    Are people having physiotherapy following an operation? What level of function do they return to? 

    What kind of regular neck exercises  can  a  patient do after operation

    Is formal physiotherapy warranted after surgery  

    What is the efficacy of physioteraphy after cervical laminectomy? 

    Can physiotherapy improve function after surgical intervention? 

    Role & extent of post-intervention rehab

    What is the efficacy of intensive early physiotherapy in clinical outcomes after decompressive surgery?