Early multimodal rehabilitation following lumbar disc surgery.
Lumbar discectomy is one of the most performed surgical spine procedures. After surgery patients often avoid exercise because of fear injury and reherniation. A recent meta-analysis showed that an exercise program 4-6 weeks after surgery improves post-operative pain and disability. The aim of this study was to compare the outcomes of patients after two different rehabilitation protocols (specific trunk exercises (STE) containing lumbal multifidus (LM) exercises vs. a general trunk exercise (GTE) protocol).
A total of 61 participants were included of which 32 followed the GTE protocol and 29 the STE protocol). In the third postoperative week the program started with once a week supervised training and daily home exercises for 6 weeks. The GTE protocol contained aerobic exercise, range of motion exercise and strengthening exercises. The STE protocol contained all the components of the GTE protocol with specific trunk muscle exercises (LM contraction, transversus abdominis - LM cocontraction) in addition.
The results showed clinical and muscle function outcomes improvements in both groups. The results were similar in both groups. Physical therapist should be directed by the individual characteristics of the individual patient in selecting the best appropriate exercises. > From: Hebert et al. Br J Sports Med. (2013) (Epub ahead of print). All rights reserved to BMJ Publishing Group Ltd.
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