| Autor: |
Hainan Yu, Carol Cancelliere, Silvano Mior, Paulo Pereira, Margareta Nordin, Ginny Brunton, Jessica J. Wong, Heather M. Shearer, Gaelan Connell, Lauren Ead, Leslie Verville, Mana Rezai, Danny Myrtos, Dan Wang, Andrée-Anne Marchand, Andrew Romanelli, Darrin Germann, Daphne To, James J. Young, Danielle Southerst, Henry Candelaria, Sheilah Hogg-Johnson, Pierre Côté |
| Jazyk: |
angličtina |
| Rok vydání: |
2024 |
| Předmět: |
|
| Zdroj: |
Brain and Spine, Vol 4, Iss , Pp 102806- (2024) |
| Druh dokumentu: |
article |
| ISSN: |
2772-5294 |
| DOI: |
10.1016/j.bas.2024.102806 |
| Popis: |
Introduction: The effectiveness of post-surgical rehabilitation following lumbar disc herniation (LDH) surgery is unclear. Research question: To investigate the effectiveness and safety of rehabilitation interventions initiated within three months post-surgery for adults treated surgically for LDH. Material and methods: This systematic review searched seven databases from inception to November 2023. Independent reviewers screened studies, assessed and extracted data, and rated the certainty of the evidence using the GRADE approach. Results: This systematic review retrieved 20,531 citations and included 25 randomized controlled trials. The high certainty evidence suggests that adding Pilates exercise to routine care and cognitive behavioral therapy may improve function immediately post-intervention (1 RCT), and that adding whole-body magnetic therapy to exercise, pharmacological and aquatic therapy may reduce low back pain intensity (1 RCT) immediately post-intervention. Compared to placebo, pregabalin did not reduce low back pain or leg pain intensity (1 RCT) (moderate to high certainty evidence). We found no differences between: 1) behavioral graded activity vs. physiotherapy (1 RCT); 2) exercise and education vs. neck massage or watchful waiting (1 RCT); 3) exercise, education, and in-hospital usual care vs. in-hospital usual care (1 RCT); 4) functional or staged exercise vs. usual post-surgical care including exercise (2 RCTs); and 5) supervised exercise with education vs. education (1 RCT). No studies assessed adverse events. Discussion and conclusion: Evidence on effective and safe post-surgical rehabilitation interventions is sparse. This review identified two interventions with potential short-term benefits (Pilates exercises, whole-body magnetic therapy) but safety is unclear, and one with an iatrogenic effect (pregabalin). |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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