Clinical trial of postoperative dynamic back exercises after first lumbar discectomy.
Ninety-six patients who had undergone first-time discectomy for herniated lumbar intervertebral discs were consecutively randomized to two physical rehabilitation programs: a program of high-intensity, dynamic back extension and abdominal exercises with occurrence of low back pain being the limiting factor or a traditional program of mild, generally mobility-improving exercises within pain limits. Both groups underwent 14 hours of treatment during a 6-week period 5 weeks after surgery. At 26 weeks' follow-up, results indicated that patients who did the high-intensity exercises experienced greater success with regard to the patient disability-index and work capabilities. After 1 year, a trend that favored the use of intensive exercises could be observed. No differences were found in pain or objective measurements. A rehabilitation program of intensive exercises with occurrence of back pain being the limiting factor appears to increase patient behavioral support, resulting in work capacity improvements and patient self-rated disability levels. The results indicate that a 6-wk, 14-hr postoperative rehabilitation program is inadequate if objective postoperative deficit improvements are the desired goal.
Manniche
C
C
Department of Neurosurgery, Glostrup Hospital.
Skall
H F
HF
Braendholt
L
L
Christensen
B H
BH
Christophersen
L
L
Ellegaard
B
B
Heilbuth
A
A
Ingerslev
M
M
Jørgensen
O E
OE
Larsen
E
E
D000328:Adult; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000534:rehabilitation* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011182:Postoperative Care; D016896:Treatment Outcome