Psychosocial factors in patients with lumbar disc herniation: enhancing postoperative outcome by the identifiction of predictive factors and optimised physiotherapy

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MARC

Johansson, Ann-ChristinÖrebro universitet,Hälsoakademin,Örebro universitet, Hälsoakademin,CHAMP (author)

Psychosocial factors in patients with lumbar disc herniation : enhancing postoperative outcome by the identifiction of predictive factors and optimised physiotherapy

BookEnglish2008

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Örebro :Örebro universitet,2008
85 s.
electronicrdacarrier

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LIBRIS-ID:oai:DiVA.org:oru-2516
ISBN:9789176686331
https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-2516URI
https://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-22365URI

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Language:English
Summary in:English

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SwePubSwePub

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Subject category:vet swepub-contenttype
Subject category:dok swepub-publicationtype

Series

Örebro Studies in Medicine,1652-4063 ;22

Notes

Psychosocial factors have been advanced as an explanation for the development of chronic disability in 20 to 30% of patients treated by lumbar disc surgery. Aims: The overall aim of this thesis was to study the role of psychosocial factors in patients undergoing first-time lumbar disc surgery in relation to the outcome of both surgery and subsequent physiotherapy. Methods: Sixty-nine patients with lumbar disc herniation undergoing first-time disc surgery participated in the studies; in addition, Study I included 162 knee patients for comparison. Psychosocial factors were assessed preoperatively, as was the activation of the physiological stress response system. Pain, disabil-ity and quality of life were assessed before, and 3 and 12 months after surgery. Coping and kinesiophobia were analysed before and one year after surgery. The results of two different postoperative training programmes were compared. Results: There were no differences between disc and knee patients regarding the presence of psychosocial stress factors preoperatively (Study I). Disc patients with low diurnal cortisol variability had lower physical function, perceived fewer possibilities to influence their pain and were more prone to catastrophise than patients with high diurnal cortisol variability (Study II). The results of clinic-based physiotherapy and home training did not differ regarding postoperative disability and pain 3 months after surgery. The home-based group had less pain and higher quality of life in comparison to the clinic-based group 12 months after surgery (Study III). Patients’ expectations of returning to work could best predict pain, disability, quality of life and sick leave one year after surgery (Study IV). Psychosocial factors were only weakly asso-ciated to pain, disability, quality of life and sick leave preoperatively. However, these associations were stronger in patients with residual pain one year after surgery. Conclusion: Psychosocial factors and, in particular, patients’ expectations regarding outcome are associated with the results of lumbar disc surgery. Assessing psychosocial factors preoperatively and developing an active home training programme after surgery could create options leading to better results for these patients.

Subject headings and genre

Lumbar disc herniation
surgery
psychosocial factors
physio-therapy
expectations
MEDICINE
MEDICIN
Medicin
Medicine

Added entries (persons, corporate bodies, meetings, titles ...)

Linton, Steven J.,ProfessorÖrebro universitet,Institutionen för beteende-, social- och rättsvetenskap,Örebro universitet, Institutionen för beteende-, social- och rättsvetenskap (thesis advisor)
Harms-Ringdahl, Karin,ProfessorKarolinska institutet (opponent)
Örebro universitetHälsoakademin (creator_code:org_t)

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