Efficacy of Dynamic Lumbar Stabilization Exercise in Lumbar Microdiscectomy

Yılmaz, Figen; Yılmaz, Adem; Merdol, Funda; Parlar, Demet; Şahin, Füsun; Kuran, Banu

doi:10.1080/16501970306125

Cited by 81 publications

(60 citation statements)

References 21 publications

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“…Indications for lumbar disc surgery were extensive or unbearable pain radiating down to the lower extremity and/ or muscle weakness and, in majority of patients, a positive straight leg raising test gave a value of \60 [49,51]. Patients may also have presented loss of patellar or Achilles reflex, cauda equina syndrome and/or regional sensory loss.…”

Section: Methodsmentioning

confidence: 99%

Risk factors for back pain-related loss of working time after surgery for lumbar disc herniation: a 5-year follow-up study

et al. 2007

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The aim of this study is to explore the occurrence and the risk factors of back-related loss of working time in patients undergoing surgery for lumbar disc herniation. One hundred and fifty-two gainfully employed patients underwent surgery for lumbar disc herniation. Two months postoperatively, those patients completed a selfreport questionnaire including queries on back and leg pain (VAS), functional capacity (Oswestry disability index-ODI, version 1.0), and motivation to work. After 5 years, lost working time was evaluated by means of a postal questionnaire about sick leave and disability pensions. The cumulative number of back pain-related days-off work was calculated for each patient. All 152 patients, 86 men and 66 women, were prescribed sick leave for the first 2 months. Thereafter, 80 (53%) of them reported back pain-related sick leave or early retirement. A permanent work disability pension due to back problems was awarded to 15 (10%) patients, 5 men (6%) and 10 women (15%). Median number of all work disability days per year was 11 (interquartile range [IQR] 9-37); it was 9 days (IQR 9-22) in patients with minimal disability (ODI score 0-20) at 2 months postoperatively and 67 days (IQR 9-352) in those with moderate or severe disability (ODI [ 20; P \ 0.001). The respective means were 61, 29, and 140 days/year. Multivariate analysis showed ODI [ 20, leg pain, and poor motivation to work to be the risk factors for extension of work disability. Results of the present study show that after the lumbar disc surgery, poor outcome in questionnaire measures the physical functioning (ODI) and leg pain at 2 months postoperatively, as well as poor motivation to work, are associated with the loss of working time. Patients with unfavourable prognosis should be directed to rehabilitation before the loss of employment.

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Section: Methodsmentioning

confidence: 99%

Risk factors for back pain-related loss of working time after surgery for lumbar disc herniation: a 5-year follow-up study

et al. 2007

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“…In the Swedish spine register, based on 1,021 disc patients surgically treated during 2003, the corresponding mean levels of leg and back pain at 12-month follow-up were 23 and 26, respectively [46]. The excellent results of the homebased training group were unexpected and contrasting to previous studies, but in those, the control groups had a less active or no exercise programme, and compliance with the prescribed home training was not reported [4,15,52].…”

Section: Discussionmentioning

confidence: 80%

“…Johannsen et al [22] found these two treatment approaches almost equally effective regarding global health aspects, disability, pain and mobility. Yilmaz et al [52], however, found supervised dynamic lumbar stabilisation training to be more beneficial than home-based training, which in turn was more effective than no training. This is a pattern that has also been reported in other studies [4,15].…”

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confidence: 96%

“…Ostelo et al [40] suggested that there is strong evidence that there is no difference between intensive and mild exercise programmes on long-term follow-up. Since that review, several randomised controlled studies have been published on this topic [4,11,12,15,19,24,25,52]. All add further support to early and active programmes, but the effect of different training programmes still tends to level out on long-term follow-up.…”

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confidence: 99%

“…Regarding patients who had undergone lumbar disc surgery, home exercises have been compared to supervised exercise programmes in four studies [4,15,22,52], the results of which are contradictory. Johannsen et al [22] found these two treatment approaches almost equally effective regarding global health aspects, disability, pain and mobility.…”

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confidence: 99%

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Clinic-based training in comparison to home-based training after first-time lumbar disc surgery: a randomised controlled trial

et al. 2008

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The effectiveness of physiotherapy after firsttime lumbar disc surgery is still largely unknown. Studies in this field are heterogeneous and behavioural treatment principles have only been evaluated in one earlier study. The aim of this randomised study was to compare clinicbased physiotherapy with a behavioural approach to a home-based training programme regarding back disability, activity level, behavioural aspects, pain and global health measures. A total of 59 lumbar disc patients without any previous spine surgery or comorbidity participated in the study. Clinic-based physiotherapy with a behavioural approach was compared to home-based training 3 and 12 months after surgery. Additionally, the home training group was followed up 3 months after surgery by a structured telephone interview evaluating adherence to the exercise programme. Outcome measures were: Oswestry Disability Index (ODI), physical activity level, kinesiophobia, coping, pain, quality of life and patient satisfaction.Treatment compliance was high in both groups. There were no differences between the two groups regarding back pain disability measured by ODI 3 and 12 months after surgery. However, back pain reduction and increase in quality of life were significantly higher in the home-based training group. The patients in the clinic-based training group had significantly higher activity levels 12 months after surgery and were significantly more satisfied with physiotherapy care 3 months after surgery compared to the home-based training group. Rehabilitation after first-time lumbar disc surgery can be based on home training as long as the patients receive both careful instructions from a physiotherapist and strategies for active pain coping, and have access to the physiotherapist if questions regarding training arise. This might be a convenient treatment arrangement for most patients.

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Rehabilitation after lumbar disc surgery

Ostelo¹,

Costa

Maher

et al. 2008

Cochrane Database of Systematic Reviews

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Efficacy of Dynamic Lumbar Stabilization Exercise in Lumbar Microdiscectomy

Abstract: Dynamic lumbar stabilization exercises are an efficient and useful technique in the rehabilitation of patients who have undergone microdiscectomy. They relieve pain, improve functional parameters and strengthen trunk, abdominal and low back muscles.

Cited by 81 publications

References 21 publications

Risk factors for back pain-related loss of working time after surgery for lumbar disc herniation: a 5-year follow-up study

Risk factors for back pain-related loss of working time after surgery for lumbar disc herniation: a 5-year follow-up study

Clinic-based training in comparison to home-based training after first-time lumbar disc surgery: a randomised controlled trial

Rehabilitation after lumbar disc surgery

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