[Intensive back exercises 5 weeks after surgery of lumbar disk prolapse. A prospective, randomized multicenter trial with a historical control group].

An intensive, dynamic rehabilitation program applied to patients who had undergone first time lumbar discectomy was evaluated in a multicentre, clinical trial. Ninety-six patients between 18 and 70 years of age who had been operated within the period September 1989 to May 1990 at the Department of Neurosurgery, Copenhagen County Hospital, Glostrup were consecutively randomized into one of two rehabilitation programs: a) traditional mild, general mobility-improving exercises within pain limits; or b) intensive dynamic back extension and abdominal exercises without low back pain being the limiting factor. Both groups underwent 14 hours of treatment over a period of six weeks, starting five weeks after surgery. Seventy-six patients operated within the period January 1989 to September 1989 formed the historical control group. The results at follow-up at 26 weeks favoured intensive exercises with regard to the patients disability-index and working capabilities. The results are statistically significant. After one year a trend favouring intensive exercises can be observed. No differences in pain or objective measurements were found. A rehabilitation program using intensive exercises without back pain being the limiting factor appears to give the patients increased behavioural support, resulting in improvements in work capacity and reduction in patients' self-rated disability.