Exercise May Help Pain and Function After Lumbar Surgery

But reviewers say the evidence for exercise-based rehab is only of low and moderate quality
By Jeff Muise
HealthDay Reporter

MONDAY, Aug. 17 (HealthDay News) -- Exercise-based rehabilitation commenced four to six weeks after lumbar disc surgery seems to improve pain and functioning in the short term, but the evidence is not strong, according to an updated Cochrane Review in the August 1 Spine.

Raymond W.J.G. Ostelo, Ph.D., of VU University Medical Centre in Amsterdam, Netherlands, and colleagues reviewed 14 randomized controlled trials on rehabilitation after first-time lumbar disc surgery. The reviewers assessed each study for risk of bias and quality of evidence, and carried out statistical pooling where possible.

For exercise programs initiated four to six weeks after surgery, the researchers compared exercise versus no treatment, high intensity exercise versus low intensity, and supervised exercise versus home exercise. They concluded that there is low-quality evidence that, in the short term, exercise is more effective than no treatment for pain, and moderate-quality evidence that exercise is more effective than no treatment for functional status. Furthermore, there is low-quality evidence that high-intensity exercise is more effective than low-intensity exercise for pain in the short term, and moderate evidence that it is more effective for functional status. There is low-quality evidence that there is no difference between supervised and home exercises for pain relief in the short term.

"Although we conclude that it is not harmful to return to activity after lumbar disc surgery, and therefore, it is not necessary for patients to stay passive after lumbar disc surgery, it is still unclear what exact components should be included in rehabilitation programs," the authors write.

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