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Intensive, progressive exercise improves quality of life following lumbar microdiskectomy: a randomized controlled trial [with consumer summary] |
Beneck GJ, Popovich JM Jr, Selkowitz DM, Azen S, Kulig K, on behalf of Physical Therapy Clinical Research Network (PTClinResNet) |
Clinical Rehabilitation 2014 Sep;28(9):892-901 |
clinical trial |
4/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
OBJECTIVE: The purpose of the study was to examine changes in quality of life measures in patients who have undergone an intensive exercise program following a single level microdiskectomy. DESIGN: Randomized controlled trial with blinded examiners. SETTING: The study was conducted in outpatient physical therapy clinics. SUBJECTS: Ninety-eight participants (53 male, 45 female) who had undergone a single-level lumbar microdiskectomy allocated to receive exercise and education or education only. INTERVENTIONS: A 12-week periodized exercise program of lumbar extensor strength and endurance training, and mat and upright therapeutic exercises was administered. OUTCOME MEASURES: Quality of life was tested with the Short Form 36 (SF-36). Measurements were taken 4 to 6 weeks postsurgery and following completion of the 12-week intervention program. Since some participants selected physical therapy apart from the study, analyses were performed for both an as-randomized (two-group) design and an as-treated (three-group) design. RESULTS: In the two-group analyses, exercise and education resulted in a greater increase in SF-36 scales, role physical (17.8 versus 12.1) and bodily pain (13.4 versus 8.4), and the physical component summary (13.2 versus 8.9). In the three-group analyses, post-hoc comparisons showed exercise and education resulted in a greater increase in the SF-36 scales, physical function (10.4 versus 5.6) and bodily pain (13.7 versus 8.2), and the physical component summary (13.7 versus 8.9) when compared with usual physical therapy. CONCLUSIONS: An intensive, progressive exercise program combined with education increases quality of life in patients who have recently undergone lumbar microdiskectomy.
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