The effectiveness of exercise programmes after lumbar disc surgery: a randomized controlled study

OBJECTIVE: To compare two different exercise programmes versus a control group, after lumbar disc surgery. DESIGN: A prospective, single-blind, randomized controlled study. SETTING: Outpatient clinic of Istanbul Faculty of Medicine, Department of Physical Medicine and Rehabilitation. SUBJECTS: Sixty patients diagnosed as having single level lumbar disc herniation with clinical examination and MRI evaluation and who had undergone lumbar discectomy (post-operative first month) at a single level. Patients with serious pathologies involving the cardiac and respiratory systems that could prevent them from doing exercises were excluded. INTERVENTION: The patients were randomly split into three groups. The first group received an intensive exercise programme and back school education while the second group received a home exercise programme and back school education. The third group was defined as the control group and did not receive education or exercise. MAIN MEASURES: The patients were evaluated at the beginning and end of the treatment with clinical parameters, pain levels, endurance tests and weight-lifting tests, modified Oswestry Disability Index, Beck Depression Inventory, Low Back Pain Rating Scale and return to work. RESULTS: The groups doing exercises experienced a decrease in the severity of pain and disability, also functional parameters showed better improvement than the control group. The intensive exercise programme was better than the home exercise programme. CONCLUSIONS: It seems that intensive exercise is more effective in reduction of pain and disability, but whether it is cost-effective is not clear.