IOSR Journal of Nursing and Health Science (IOSR-JNHS) e-ISSN: 2320–1959.p- ISSN: 2320–1940 Volume 7, Issue 5 Ver. IV. (Sep.-Oct .2018), PP 61-78 www.iosrjournals.org DOI: 10.9790/1959-0705046178 www.iosrjournals.org 61 | Page Impact of Nursing Physical Training Program on Clinical Outcomes for Patients Undergoing Cervical Spine Surgery Samah R.Shaheen 1 , Sanaa Alaa Eldeen 2 , Maha Adel Salem 3 , Osama Abdelaziz 4 1 (Medical - Surgical Nursing / Faculty of nursing, Alexandria University, Egypt,) 2 (Medical - Surgical Nursing / Faculty of nursing, Alexandria University, Egypt) 3 (Medical - Surgical Nursing / Faculty of nursing, Alexandria University, Egypt) 4 (Neurosurgery department / Faculty of medicine, Alexandria University, Egypt) Corresponding author: Samah Ramadan Abstract: Background: Cervical spine disorders (CSD) including degenerative disc disease (“DDD”) are common causes of neck pain. CSD are characterized by degenerative changes in the intervertebral discs. It can be noticeable anywhere along the spine. Population-based surveys have indicated lifetime prevalence rates for neck pain somewhere in the range of 67 to 71%, whereas 13- 22% of the population in industrialized society encounter neck pain at any time point. CSD also account for an essential number of physical therapy outpatient visits yearly. Objectives: Determine the influence of nursing physical training program on the clinical outcome of patients undergoing cervical spine surgery. Setting: The study was done at the neurosurgery department at Alexandria Main University Hospital and the affiliated Outpatient Clinic. Subjects: Subjects of this study were a convenient sample of 40 adult patients with cervical spondylosis, canal stenosis and cervical disc prolapse undergoing cervical spine surgery. They were sequentially divided into 2 equal groups; the first was the control group which comprised 20 patients and exposed to routine care only, the second was the study group and comprised 20 patients and they received the nursing physical training program. Tools: Two tools were used Tool I: Cervical Spine Surgery Patients’ Assessment and Tool II: Neck Disability Index. Results: There were highly statistical significant differences between study and control regarding pain intensity 1 month after the surgery. It was found that among the study group, the mean score of all assessed muscles strength was increased from preoperative day to two weeks postoperatively and one month after surgery. This increase within the study group was statistically significant .The mean scores of all reflexes among study group were 2.0± 0.00 one month postoperative which denotes the improvement to normal response. A statistically significant improvement in the disability level was noticed among the study group. Conclusion: Applying nursing physical training program significantly enhanced the studied patients’ pain intensity, gait, muscle strength, reflexes, and neck disability index postoperatively than their controls. Keywords - Cervical Spine Disorders, Degenerative Disc Disease, Nursing Physical Training Program, Neck Disability Index --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 18-09-2018 Date of acceptance: 03-10-2018 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction Cervical DDD is a typical reason for pain and disability, affecting around two-thirds of adults in the U.S. Most symptomatic cases present between 40 and 60 years old, although numerous people never develop symptoms MRI studies have recorded DDD in 60% of asymptomatic persons greater than 40 years and 80% of patients over 80 years (1, 2) . Around 15% United Kingdom’s clinic-based physiotherapy and 30% Canada’s Chiropractic referrals are for neck pain. Neck pain provides up to 2% of general specialist consultations in the Netherlands (3) . Approximately 50–85% of individuals with neck pain do not experience full resolution of symptoms and some may experiences chronic pain (4) . DDD of the cervical spine is a natural consequence of aging that results in gradual deterioration of cervical intervertebral discs as the capacity of these discs to absorb the stress and shock of vertebral movement decreases, they become inelastic and cause a settling of the spinal column structure and abnormal spinal movement patterns. This process in turn causes the development of anomalous bony growths and/or spurs (spondylosis), osteoarthritis, and/or herniation of at least one cervical disc (5) . These conditions may in turn cause radiculopathy, or peripheral nerve root impingement. Cervical radiculopathy symptoms encompass arm and neck pain, and weakness, tingling, or numbness in the upper limbs. Less commonly, cervical DDD progression and its sequelae may directly compress the spinal cord parts (myelopathy), influencing gait and balance in addition to causing arm and/or leg weakness and numbness (6) .