Physical activity patterns of patients immediately after lumbar surgery

Purpose: To describe the physical activity patterns of patients in the first week after lumbar surgery, and to investigate factors that potentially limit walking time early after surgery. Materials and methods: Adults undergoing lumbar decompression, discectomy and/or fusion surgery (N = 216, mean age 62 years, SD 13.9) were invited to participate. Walking time and step count were recorded for the first seven post-operative days, using an ActivPAL accelerometer. Participants recorded daily pain scores, supervision requirements while walking, and any complications that prevented walking. Results: On the first post-operative day, participants spent an average of 17 min (SD 20) walking, by Day 6, participants spent an average of 53 min (SD 38) walking. Participants who reported minor post-operative complications had a significantly lower step count than those without complications (p < 0.01). A lower step count was associated with a longer time to achieve independent mobility (r= -0.60, 95% CI -0.68 to -0.50), and a longer hospital admission (r= -0.70, 95% CI -0.76 to -0.63). Conclusions: This study found that patients walk for less than an hour a day over the week after lumbar surgery. Further research is required to investigate whether intervention designed to increase walking time improves post-operative activity and longer-term patient outcome. IMPLICATIONS FOR REHABILITATION While resuming walking after lumbar surgery is a common focus of early rehabilitation, little is known about how much walking patients do, or how walking impacts recovery. The findings from this study describe activity patterns early after lumbar surgery, which may be used to inform patients about normal post-operative recovery. A lower post-operative step count was associated with several patient factors, including a fusion procedure and more severe post-operative pain, which may be used to guide peri-operative care and rehabilitation protocols.