Spinal stenosis is the most common cause of degenerative spinal surgery. The majority do not achieve the global recommendations for health-promoting physical activity before or after surgery. Patients with a low level of physical activity and a high degree of fear of movement are at an increased risk of poorer health outcomes after surgery. Increasing the number of steps per day is a way to increase physical activity, which in long term can lead to health benefits. In addition, a digital format is a way to increase the availability of physiotherapy to strive for equal rehabilitation. The overall purpose of the research project is to improve health outcome and increase the availability of rehabilitation for patients at high risk of negative health outcomes after spinal surgery due to spinal stenosis through Get Back, a person-centered and digital program with a focus on physical activity. Before conducting a large-scale study, the investigators want to conduct a study that aims to investigate and develop the Get Back program regarding content and dose, treatment fidelity as well as feasibility in terms of study procedure, compliance, and acceptability. Approximately thirty patients with lumbar spinal stenosis and an identified risk profile for poorer postoperative outcomes will be recruited from two spine clinics in Sweden. The program involves meeting a physiotherapist digitally (through video call) approximately 1 week before surgery to formulate a person-centered health plan. The health plan is monitored and progressed by the physiotherapist by video until eleven weeks after surgery. The Get Back program includes 5 sessions (1 hour each) which are supplemented with 5 booster sessions (30 minutes) to reinforce the intervention. Get Back is based on three key components that run through all sessions. These are person-centeredness, behavioral medicine techniques to reduce fear of movement and worries about pain, as well as to optimize physical activity. The physiotherapist supports the participant's individual resources and abilities through validated behavioral medicine methods in combination with education/communication/knowledge support and behavior-strengthening tools (which are also used in-between sessions) to achieve the participant's personal goals linked to physical functioning, physical activity, and health. The program will be compared to standard physiotherapy.
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Change in variables related to intervention content.
Timeframe: Once a week during the 12-week study period.
The intervention participants frequency and length of contact with the study physiotherapist.
Timeframe: Continuously during the 12 week intervention.
Checklist of included components at each treatment session.
Timeframe: Continuously during the 12 week intervention.
Analysis of audio recordings from the intervention sessions.
Timeframe: Continuously during the 12 week intervention.
Type and frequency of possible adverse events.
Timeframe: Continuously during the 12 week intervention.
Percentage of patients eligible after the screening procedure.
Timeframe: Through study completion, an average of 6 month.
Number of intervention sessions attended out of planned.
Timeframe: Through study completion for each intervention participant, an average of 12 weeks.
Acceptability of data collection methods measured with a study specific questionnaire.
Timeframe: At the end of each participants 12 week study period.
Participants experiences of the intervention collected via telephone interviews.
Timeframe: At the end of intervention/after 12 weeks.