Authors: (including presenting author): :
Choi TL(1), Tam KL(1), ,Cheung TKR(1), Tsang HC(1), To YL(1), So WY(2)
Affiliation: :
(1) Physiotherapy Department, North District Hospital (2) Hospital Chief Executive Office, North District Hospital
Keyword 1: :
Prehabilitation
Keyword 2: :
Physiotherapy
Keyword 3: :
Peri-operative
Keyword 4: :
endoscopic spine surgery
Introduction: :
A structured peri-operative physiotherapy programme for patients undergoing unilateral biportal endoscopic unilateral laminotomy for bilateral decompression (UBE ULBD) was implemented at North District Hospital in February 2025.
Objectives: :
The programme aims to enhance pre-operative preparedness, reduce peri-operative pain, optimize recovery, and facilitate early discharge through multidisciplinary collaboration.
Methodology: :
The programme commenced with a Physiotherapist-led education and assessment session to prepare patients for surgery, followed by outpatient prehabilitation focusing on lower limb strengthening and cardiovascular training. Each 60-minute session is delivered one to two times per week, with training intensified one to two months pre-operatively to optimize surgical readiness. After surgery, early mobilization, including same-day out-of-bed ambulation when indicated, is provided to promote recovery and facilitate early discharge. A total of forty-four patients undergoing UBE ULBD between January and November 2025 were recruited. Nineteen patients (mean age 64.8 years) who had surgery between January and March 2025 without prehabilitation formed the control group, while twenty-five patients (mean age 69.4 years) who underwent surgery between March and November 2025 received prehabilitation. Outcome measures were Numeric Pain Rating Scale (NPRS), Modified Functional Ambulation Category (MFAC), and length of hospital stay.
Result & Outcome: :
The prehabilitation group had a median length of stay of five days compared with six days in the control group. In the prehabilitation group, after an average of five outpatient sessions, NPRS improved significantly from 6.9 at baseline to 5.3 one day before surgery. After surgery, pain decreased in both groups: from 5.3 to 2.5 in control group and from 5.3 to 2.2 in the prehabilitation group at discharge from hospital. Functional outcomes were comparable, with both groups achieving a median MFAC score of six at discharge. No adverse events were reported in the prehabilitation programme. The peri-operative physiotherapy programme was associated with reduced peri-operative pain and shorter hospital stay while preserving post-operative mobility in patients undergoing UBE ULBD. This structured programme may support more efficient peri-operative recovery in endoscopic spine surgery.
