EARLY ACTIVE TRAINING AFTER LUMBAR DISKECTOMY - A PROSPECTIVE, RANDOMIZED, AND CONTROLLED-STUDY

Study Design. A prospective, randomized, and controlled study was cond ucted. Objectives. To evaluate two training programs, both which start ed immediately after lumbar discectomy. Summary of Background Data. In previous studies, patients began physiotherapy between 4 weeks and 60 months after surgery. No studies have been conducted to evaluate a ph ysiotherapy program that begins immediately after surgery. Method. Twe nty-six patients were treated according to an early active training pr ogram. Twenty-six patients were treated with a traditional, less activ e training program (control group). All patients were examined immedia tely before and after surgery and 3, 6, 12, and 52 weeks after surgery by an unbiased observer. Two years after surgery, patients completed a questionnaire. Range of motion of the lumbar spine and straight leg raising were measured. Pain intensity and location was measured by a v isual analog scale. The duration of sick leave was documented. Results . Six and 12 weeks after surgery, patients with dominating residual le g pain had significantly less intense pain in the early active trainin g group than those in the control group (P < 0.05). Twelve weeks after ter surgery, range of motion of the lumbar spine was significantly mo re increased in the early active training group (P < 0.01). One year a fter surgery, there was no,, significant difference between the groups regarding the duration of sick leave, results in a positive straight leg raising, or pain intensity. Twenty-two (88%) patients in the early active training group and 16 (67%) in the control group were satisfie d with the treatment outcome 2 years after surgery (P < 0.10). Conclus ions. Patients rehabilitated according to the early active training pr ogram had a better short-term outcome of objective values, At 2 years' follow-up, more patients were satisfied with the result of the operat ion. The early active treatment program is recommended.