SUPERVISED ENDURANCE EXERCISE TRAINING COMPARED TO HOME TRAINING AFTER FIRST LUMBAR DISKECTOMY - A CLINICAL-TRIAL

Objective:We performed a randomised trial to evaluate if intensive sup ervised training of the back should be offered to all patients after a first lumbar diskectomy. Methods:Forty consecutive patients were, aft er a first lumbar diskectomy, randomly allocated to 2 groups undergoin g ''supervised training'' twice a week for 3 months in an outpatient c linic or ''home training'' after 2 hours of instruction. Results:The t wo rehabilitation models both showed a significant effect on. spinal m obility, isokinetic trunk flexion strength, isokinetic trunk extension strength and daily function. These improvements were unchanged at fol low up 3 months later. The pain score remained unchanged however, thro ughout the trial in both groups. No differences in effect between the two rehabilitation models could be found for any of the assessed param eters. Thirteen patients did not complete the trial including 9 from t he supervised endurance trained group, mainly because of increased pai n and reprolaps (n=4). Four patients dropped out of the home trained g roup, only one because of increased pain. The differences in drop-out rate and training side effects were, however, not statistically signif icant. Conclusion:We conclude that if is not worthwhile to implement 3 months of supervised intensive endurance training as opposed to home training in all cafes of first lumbar diskectomy, although a beneficia l effect and better compliance might be found for a selected group of such patients.