Orthopedic Clinic Kysthospitalet in Hagevik, Haukeland University Hospital, Bergen, Norway.
Western Norway University of Applied Sciences, Bergen, Norway.
Physiother Res Int. 2020 Oct;25(4):e1864. doi: 10.1002/pri.1864. Epub 2020 Jun 29.
The aim of this study was to compare two physiotherapy interventions following lumber disc surgery regarding effect on pain, functioning and fear of movement.
This study is a prospective randomized controlled study. When admitted to hospital for first time lumbar disc surgery, the participants were randomized to one of two post-operative intervention groups: one group received information only and the other exercise in combination with information. Outcomes were collected at baseline, 6-8 weeks and 12-months post-surgery. The primary outcome was to record changes in back/hip pain and leg pain. Secondary outcomes were evaluation of changes in function, fear-avoidance beliefs and kinesiophobia.
Seventy patients completed the study and were included in the analysis, of which 37 were randomized to the group receiving information only and the remaining 33 receiving both exercise and information. For primary outcomes, at 12 months postoperatively, the group receiving both exercise and information had significantly lower leg pain compared with those receiving only information (p < .033). For secondary outcomes, at 12 months postoperatively, a significant difference (p < .027) was detected for function, which favoured those that received both exercise and information. There was no significant difference in the results for the other secondary outcomes. Both groups showed clinically important changes in relation to pain and function from baseline to 12 months. The effect of treatment showed a statistically significant difference in favour of exercise and information, but the difference was not clinically relevant.
Exercise in combination with information reduced leg pain and improved function, which was statistically more evident over a period of time. Postoperative physiotherapy after lumbar disc surgery could include exercises in addition to information, but perhaps not for all patients, as both groups improved, and the difference between the two groups was not clinically relevant.
本研究旨在比较两种物理治疗干预措施对腰椎间盘手术后疼痛、功能和运动恐惧的影响。
这是一项前瞻性随机对照研究。当首次因腰椎间盘手术住院时,参与者被随机分为术后干预组之一:一组仅接受信息,另一组接受运动结合信息。在基线、6-8 周和 12 个月时收集结果。主要结果是记录背部/臀部疼痛和腿部疼痛的变化。次要结果是评估功能、恐惧回避信念和运动恐惧的变化。
70 名患者完成了研究并纳入了分析,其中 37 名随机分为仅接受信息组,其余 33 名接受运动和信息组。在术后 12 个月时,接受运动和信息的组的腿部疼痛明显低于仅接受信息的组(p<0.033)。在次要结果中,在术后 12 个月时,功能方面存在显著差异(p<0.027),接受运动和信息的组更有利。其他次要结果无显著差异。两组在疼痛和功能方面均表现出从基线到 12 个月的临床重要变化。治疗效果显示出统计学上有利于运动和信息的差异,但差异无临床意义。
运动结合信息可减轻腿部疼痛并改善功能,这在一段时间内更为明显。腰椎间盘手术后的术后物理治疗可以包括运动以外的信息,但可能不是所有患者都需要,因为两组都有所改善,两组之间的差异无临床意义。