Development of an optimised 1:1 physiotherapy intervention post first-time lumbar discectomy: a mixed-methods study

Area of Science:

• Orthopedics
• Rehabilitation Medicine
• Evidence-Based Practice

Background:

• Post-lumbar discectomy care requires effective physiotherapy interventions.
• Current practices may lack standardization and patient-centered flexibility.
• Optimizing physiotherapy is crucial for patient recovery and outcomes.

Purpose of the Study:

• To develop an optimized 1:1 physiotherapy intervention for patients post-lumbar discectomy.
• To ensure the intervention reflects best available evidence and patient-centered principles.
• To create a flexible intervention adaptable to individual patient needs.

Main Methods:

• A mixed-methods approach combining evidence synthesis, expert review, and focus groups.
• Systematic reviews and surveys informed a draft intervention.
• Expert panels and patient/physiotherapist focus groups provided feedback and assessed acceptability.

Main Results:

• An optimized 1:1 physiotherapy intervention was developed, incorporating best evidence and patient-centered flexibility.
• The intervention consists of up to 8 sessions over 8 weeks, commencing 4 weeks post-surgery.
• Both patients and physiotherapists found the intervention acceptable.

Conclusions:

• A rigorous development process yielded an optimized 1:1 physiotherapy intervention for post-lumbar discectomy.
• The intervention aligns with best practices and offers tailored management.
• Five UK spinal centers agreed to implement this intervention in a future randomized controlled trial.