A new study looking at the effects of 'prehabilitation' for patients awaiting one of the most common types of spinal surgery has been awarded $1.49M through the National Health & Medical Research Council (NMHRC) Partnership Projects grants program, with additional financial support from Ramsay Hospital Research Foundation. Other partners are Musculoskeletal Health Australia, Northern Sydney Local Health District, Western Sydney Local Health District and the NSW Agency for Clinical Innovation (ACI).
Led by Professor Manuela Ferreira, Program Head, Musculoskeletal Health at The George Institute for Global Health and UNSW Sydney, the research will assess the feasibility and potential savings to the health system of an online prehabilitation program for patients preparing for lumbar spinal surgery for low back pain.
Prehabilitation involves preparing patients physically and mentally for surgery through education, exercise, and mental health support, and studies in Sweden, Denmark, and Canada have demonstrated improved outcomes and reduced hospital stays by an average of two days for lumbar spinal surgery.
Low back pain affects 1 in 4 Australians and approximately 620 million people worldwide. In Australia, nearly 30,000 surgical procedures are performed each year to manage the condition, with numbers expected to rise as the population ages.
Spinal surgery costs Australians almost $2 billion a year. NSW ACI has prioritised the need to improve outcomes for spinal surgery.
"Public patients often wait up to 12 months for lumbar spinal surgery, receiving little to no care or preparation in that time. This situation often leads to a decline in physical and mental health in the lead-up and afterwards, with many people experiencing poorer surgical outcomes, extended hospital stays, and a greater risk of readmission.
Our study will test a scalable digital program that can be provided to any patient, even those in remote or regional areas, and which enables collaboration across care teams. Importantly, it will support spinal surgery patients to be strong for surgery, which enables them to smoothly transition from hospital back home and to recover quickly.
By:Professor Manuela Ferreira
Program Head, Musculoskeletal Health, The George Institute for Global Health
The initial eight-week online program co-designed with clinicians and consumers to deliver education, guided exercise, coaching, and psychological support to NSW Health patients in NSLHD and WSLHD hospitals awaiting lumbar spine surgery will be compared in a randomised trial with standard care (basic surgery information and post-operative self-care). Recovery time, duration of hospital stay, frequency of readmission and repeat surgeries, and cost-effectiveness will all be measured. If effective, a wider program roll-out could cut wait times and ease pressure across the national health system.
The PRESTIGE (Preoperative Rehabilitation Evaluation and Spinal Surgical Treatment Intervention for Enhanced Recovery)study will be conducted in partnership with the NSW Agency for Clinical Innovation (ACI), Musculoskeletal Health Australia, NSLHD, WLSHD, and the Ramsay Health Research Foundation.
