S Demir1, D Dulgeroglu, A Cakci. 1. Specialist in Physical Medicine and Rehabilitation Ankara Diskapi Yildirim Beyazit Education and Research Hospital Physical Medicine and Rehabilitation Clinic - denizdulgeroglu@gmail.com.
Abstract
BACKGROUND: Various lumbar exercise programs are prescribed for rehabilitation purposes following microdiscectomy applied for the treatment of lumbar disk herniation. The literature contains several studies on this subject. However, there are no studies investigating the effects of supervised dynamic lumbar stabilization exercises on fear and fear/regression attitudes of patients and on their return to work. AIM: This study investigates the effects of supervised dynamic lumbar stabilization exercises during postoperative rehabilitation on spinal mobility, pain, functional status, return to work, quality of life, and fear/regression attitude of patients who underwent lumbar microdiscectomy for the first time. SETTING: The study was conducted at physical therapy and rehabilitation clinics. STUDY DESIGN: A randomized clinical trial comparing exercise programs after lumbar microdiscectomy. PATIENTS SAMPLE: Forty-four lumbar microdiscectomy patients were randomized into two groups. OUTCOME MEASURES: Each group was assessed in terms of low back pain, leg pain, spinal mobility, Oswestry Disability Index (ODI), and Nottingham Health Profile (NHP), at the postoperative first, second, and sixth months. Fear/regression beliefs and level of pain were evaluated through the Fear Avoidance Belief Questionnaire (FABQ). METHODS: Forty-four patients were randomly divided into two equal groups of 22 subjects, respectively, as a study group with Dynamic Lumbar Stabilization (DLS) exercises and home exercises, and a control group with only home exercises for a period of four weeks. RESULTS: Leg pain decreased more in the study group compared with the control group (P=0.004). Spinal mobility scores demonstrated greater increases in the study group (P<0.001). Statistically greater reductions were observed in the study group regarding ODI and FABQ scores (P<0.017). CONCLUSION: DLS exercises may be recommended to patients following spinal surgery due to their benefits in reducing pain, increasing spinal mobility, and ensuring faster return to work periods.
BACKGROUND: Various lumbar exercise programs are prescribed for rehabilitation purposes following microdiscectomy applied for the treatment of lumbar disk herniation. The literature contains several studies on this subject. However, there are no studies investigating the effects of supervised dynamic lumbar stabilization exercises on fear and fear/regression attitudes of patients and on their return to work. AIM: This study investigates the effects of supervised dynamic lumbar stabilization exercises during postoperative rehabilitation on spinal mobility, pain, functional status, return to work, quality of life, and fear/regression attitude of patients who underwent lumbar microdiscectomy for the first time. SETTING: The study was conducted at physical therapy and rehabilitation clinics. STUDY DESIGN: A randomized clinical trial comparing exercise programs after lumbar microdiscectomy. PATIENTS SAMPLE: Forty-four lumbar microdiscectomy patients were randomized into two groups. OUTCOME MEASURES: Each group was assessed in terms of low back pain, leg pain, spinal mobility, Oswestry Disability Index (ODI), and Nottingham Health Profile (NHP), at the postoperative first, second, and sixth months. Fear/regression beliefs and level of pain were evaluated through the Fear Avoidance Belief Questionnaire (FABQ). METHODS: Forty-four patients were randomly divided into two equal groups of 22 subjects, respectively, as a study group with Dynamic Lumbar Stabilization (DLS) exercises and home exercises, and a control group with only home exercises for a period of four weeks. RESULTS: Leg pain decreased more in the study group compared with the control group (P=0.004). Spinal mobility scores demonstrated greater increases in the study group (P<0.001). Statistically greater reductions were observed in the study group regarding ODI and FABQ scores (P<0.017). CONCLUSION: DLS exercises may be recommended to patients following spinal surgery due to their benefits in reducing pain, increasing spinal mobility, and ensuring faster return to work periods.
Authors: Nicole Vogel; Stefan Schandelmaier; Thomas Zumbrunn; Shanil Ebrahim; Wout El de Boer; Jason W Busse; Regina Kunz Journal: Cochrane Database Syst Rev Date: 2017-03-30