Priority 6 from the Degenerative Cervical Myelopathy PSP
|UNCERTAINTY: What is the role of rehabilitation following surgery for DCM? Can a structured postoperative rehabilitation improve outcome following surgery for DCM? What are the most effective strategies? (JLA PSP Priority 6)|
|JLA question ID||0097/6|
|Explanatory note||A systematic review by Badran et al (2018) was conducted to evaluate the role of postoperative physiotherapy in patients with DCM. This review identified one small, retrospective study that met inclusion criteria. Yap et al (1993) concluded that patients can improve their postoperative functional status through rehabilitation. Furthermore, there are two registered randomized controlled trials that aim to investigate the efficacy of postoperative rehabilitation (physiotherapy and occupational therapy) in DCM (NCT02842775 and NCT03320759). There is no current standard for postoperative care in DCM or guidelines as to the approprate frequency, content and duration of rehabilitation.|
A systematic review on the role of postoperative physiotherapy concluded there was insufficient evidence to make any recommendations. No other systematic reviews, scoping reviews or guidelines were identified.
|Health Research Classification System category||Neurological|
|Extra information provided by this PSP|
|Original uncertainty examples||
Can physiotherapy improve function after surgical intervention? ~ Does a structured post surgical rehabilitation plan improve outcomes? ~ What are the most effective physical modalities ad exercise programs in management of DCM after surgical treatment? ~ Which patients benefit from postoperative rehabilitation? ~ What is the optimum rehabilitation programme (frequency and length) for patients with DCM post operatively?
|Submitted by||Spinal Surgeons x 13 ~ Other healthcare professionals x 10 ~ People with DCM and their supporters x 4|
|PSP unique ID||0097|
|PSP name||Degenerative Cervical Myelopathy|
|Total number of uncertainties identified by this PSP.||76 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)|
|Date of priority setting workshop||20 November 2019|