Physiotherapy-based rehabilitation following disc herniation operation: results of a randomized clinical trial
| Autor: | Martin Nuhr, Karl-Ludwig Resch, Andreas Schöggl, Horst Müller, Celal B. Erdogmus, Ronald Sabitzer, Karl Ungersböck, Wolf Osterode, Martin Posch, Gerold Ebenbichler |
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| Rok vydání: | 2007 |
| Předmět: |
Research design
Adult Male medicine.medical_specialty Randomization Time Factors medicine.medical_treatment Kaplan-Meier Estimate law.invention Randomized controlled trial law Rating scale medicine Humans Orthopedics and Sports Medicine Single-Blind Method Pain Measurement Massage Rehabilitation Lumbar Vertebrae business.industry Recovery of Function Middle Aged Low back pain Musculoskeletal Manipulations Clinical trial Treatment Outcome Research Design Physical therapy Female Neurology (clinical) medicine.symptom Sick Leave business Low Back Pain Intervertebral Disc Displacement Diskectomy |
| Zdroj: | Spine. 32(19) |
| ISSN: | 1528-1159 |
| Popis: | Study design Three-group, randomized, single blinded, controlled trial. Objective To test the effectiveness of physiotherapy-based rehabilitation starting 1 week after lumbar disc surgery. In addition, we tried to estimate the contribution of specific effects to the observed outcome (efficacy). Summary of background data Physiotherapy-based rehabilitation is usually recommended for patients following lumbar disc surgery. Few and conflicting data exist for the relative effectiveness of this intervention. Methods A total of 120 patients following first-time, uncomplicated lumbar disc surgery were randomly assigned to "comprehensive" physiotherapy, "sham" neck massage, or no therapy. Before enrollment, all subjects completed a minimal physiotherapeutic intervention. Physiotherapy was administered by experienced physiotherapists and consisted of 20 sessions per patient over 12 weeks. Masseurs administered "sham massage" to the neck. The amount of treatment time was equal to that of physiotherapy. The main outcome measure was the Low Back Pain Rating Score (LBPRS) at 6 and 12 weeks, and 1.5 years after randomization. Secondary parameters were patients' overall satisfaction with treatment outcome and socioeconomic and psychologic measures. Results At the end of therapy (12 weeks), the LBPRS revealed a significantly better improvement in the physiotherapy group than in the untreated group. LBPRS outcome, however, did not significantly differ between physiotherapy and "sham" therapy. There was a tendency toward significance between the sham therapy and no therapy. Within the 1.5-year follow-up, LBP rating scales remained significantly improved compared with baseline, but there were no significant outcome differences. No statistically significant between-group differences were found for the secondary outcome parameters. Conclusion As compared with no therapy, physiotherapy following first-time disc herniation operation is effective in the short-term. Because of the limited benefits of physiotherapy relative to "sham" therapy, it is open to question whether this treatment acts primarily physiologically in patients following first-time lumbar disc surgery, but psychological factors may contribute substantially to the benefits observed. |
| Databáze: | OpenAIRE |
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