A Person-Centered Prehabilitation Program Based on Cognitive-Behavioral Physical Therapy for Patients Scheduled for Lumbar Fusion Surgery: A Randomized Controlled Trial.

Participants were younger and less disabled than the broader Swedish spine registry population, so the result may not apply to more disabled patients. Conventional care was delivered by local physical therapists and was not controlled, so it may have varied. Most patients had surgery at the same clinic where active treatment was delivered, which could have increased contamination between groups. The active intervention was controlled by a manual, but delivery was not observed during the trial, so treatment fidelity is uncertain. The significant secondary quality-of-life difference did not reach the minimal important change. Patients missing follow-up had higher baseline fear of movement, depression, or worse balance, so missing data may have influenced some results.

The funders were AFA Research Funding, Eurospine Research Grants, Swedish Research Council, Health and Medical Care Executive Board of the Västra Götaland Region, and Doctor Felix Neubergh Grants. The paper states that the funders played no role in the design, conduct, or reporting of the study.

Do not conclude that this prehabilitation program is superior to conventional care. The primary disability outcome was null, and the significant health-related quality-of-life finding was secondary and did not reach the minimal important change.