Spinal surgery patients in London recruited to new clinical trial to find out if exercise helps them get better
More than 300 people in west London who have had spinal surgery to relieve back pain are to be offered the chance to take part in a major new clinical trial aimed at finding out if post-operative rehabilitation, including exercise, helps them get better.
A team at Imperial College's musculoskeletal surgery department at Charing Cross Hospital in Hammersmith have been awarded funding of £150,000 over 18 months from the Arthritis Research Campaign to carry out the work.
Patients will be recruited from seven hospitals in London; Hammersmith and Charing Cross, St Mary's, Ravenscourt Park, St Thomas's, Ealing, West Middlesex and Guy's.
The FASTER trial aims to find whether a six-week programme of exercise and advice will help back pain patients recover from spinal surgery and get back to normal activities, or whether up-to-date information and advice is just as good. Currently, post-operative care is patchy, minimal and varies from surgeon to surgeon, and research has shown that many people who have undergone spinal surgery remain disabled, and are unable to return to work or to normal daily activities.
"Back pain is a very common and very expensive problem, and sometimes people with a slipped disc or as a result of the narrowing of the bony canal in the spine as a consequence of wear and tear or previous injury require surgery," explained Dr Alison McGregor, senior lecturer in biodynamics at Imperial College, who is leading the trial.
"Although this surgery is known to be successful in reducing the pain, it doesn’t always improve the patients' level of physical, social or other activities. We think that these patients don’t do very well because of the general deconditioning of their spinal muscles and cardiovascular system, which can’t be addressed by surgery, but which we think can be addressed by exercise and activity.
"At present, there is a wide variation in the amount and type of advice received by many patients after a back operation-some surgeons tell their patients to rest for many weeks, others encourage an early resumption of physical activities. Nor do we know the best time when patients should return to work.
"Previous studies have been too small to provide clear answers to these questions. This study will help us find out whether rehabilitation classes are really needed, or if sound evidence-based written advice is just as good."
People recruited to take part in the trial will be randomised into four groups.
One will get the usual post-operative care offered by surgeons, which will include a follow-up outpatient appointment and general advice on getting back to normal.
The second will be put on an hour-long, six-week class run by a physiotherapist including general aerobic fitness work, stretching, strengthening and endurance training for the back, abdominal and leg muscles, advice on lifting and self-motivation.
A third group will be given an information booklet which contains the latest up-to-date evidence-based advice on post-operative care, and fourth group will take part in the exercise programme and also be given the booklet. All patients will be followed up for one year.
If you would like to take part in the trial please contact trial co-ordinator Jack Kerr on 0208 383 4424 or email jack.kerr@imperial.ac.uk
