Abstract
Objective
To investigate whether immediate commencement of exercises after lumbar microdiscectomy enabled patients to become independently mobile more rapidly with no increase in risk of complications.
Study design
Randomised, single-blind, controlled trial.
Setting
One secondary care teaching hospital in the UK.
Participants
Thirty patients were recruited. The follow-up rate was 28 (93%) at 4 weeks and 23 (77%) at 3 months.
Interventions
Patients were randomised to an intervention group commencing exercises within 2
hours after surgery, or a control group commencing exercises on the first postoperative day.
Main outcome measures
Primary outcome measures included the time taken for the patient to become independently mobile and attain discharge criteria following surgery. Secondary outcome measures were disability and pain scores collected before surgery, and 4 weeks and 3 months after surgery; and return to work rates.
Results
The two groups were similar at baseline. The results indicated significantly reduced time to independent mobility [median 7 vs 19hours, median difference 9hours, 95% confidence interval (CI) 1.25 to 14.5, P=0.009] and return to work (median 6 vs 8 weeks, median difference 2 weeks, 95% CI 0 to 6, P=0.002) in the intervention group compared with the control group. At 15hours after surgery, independent mobility was attained in 80 and 40% of the intervention and control groups, respectively. There were no significant differences in disability and pain scores at 4 weeks and 3 months.
Conclusions
Immediate commencement of exercises following first-time single-level lumbar microdiscectomy enabled patients to become independently mobile more rapidly and return to work sooner. Immediate commencement of exercises may enable patients to be discharged earlier, with associated cost benefits to health care and no increase in the rate of revision surgery.
Citation
A prospective, randomised trial of immediate exercise following lumbar microdiscectomy: a preliminary study
R.J. Newsome, S. May, N. Chiverton, A.A. Cole
Physiotherapy - December 2009 (Vol. 95, Issue 4, Pages 273-279, DOI: 10.1016/j.physio.2009.06.004)