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Form IDs Spinal Patients Likely to Stick With Therapy

13-item questionnaire predicts who will be more active in post-surgery rehab

SUNDAY, Oct. 5 (HealthDay News) -- Doctors may soon be able to use a simple questionnaire to predict which spine surgery patients will engage in their own physical therapy, say Johns Hopkins researchers.

The 13-item questionnaire, known as the Patient Activation Measure (PAM), was developed in 2004 to assess patients' abilities to play active roles in their health care. The PAM has been used previously with chronic diseases such as HIV, type 2 diabetes and hypertension.

"It has long been known that physical therapy after spine surgery greatly improves outcomes, but to date, there has been no easy-to-administer, standardized method for assessing a patient's willingness to adhere to therapy," study author Richard L. Skolasky, of the Department of Orthopaedic Surgery at Johns Hopkins University School of Medicine, said in a university news release.

In this study, which is published in the Oct. 1 online edition of Spine, 65 Johns Hopkins patients who were to undergo their first surgical treatment for a degenerative spine disease completed the PAM before surgery.

For six weeks, the patients kept track of their attendance in physical therapy sessions. After the last session, the physical therapists rated the patients' attitude, need for prompts, understanding of the importance of therapy, and activity during sessions.

The researchers found that the patients who scored high on the PAM were 38 percent more likely to attend physical therapy and were rated as significantly more engaged in rehabilitation by their therapists, compared with the patients who had low PAM scores.

Specifically, patients with the lowest PAM scores attended 55.6 percent of their therapy sessions, compared with a 94.1 percent attendance rate in those with the highest scores.

"These results were very encouraging, and since the PAM is easy to administer, it may provide a practical component to a patient's preoperative treatment," said Skolasky.

Skolasky noted that before spine surgeons begin using the questionnaire, methods for improving PAM scores must be developed. He and his colleagues are planning a study to test methods for improving low PAM scorers' involvement in their own health care.

More information

The North American Spine Society has more about spine surgery.

SOURCE: Johns Hopkins Medicine, news release, Oct. 1, 2008

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