Manniche C, Skall H F, Braendholt L, Christensen B H, Christophersen L, Ellegaard B, Heilbuth A, Ingerslev M, Jørgensen O E, Larsen E
Department of Neurosurgery, Glostrup Hospital.
Spine (Phila Pa 1976). 1993 Jan;18(1):92-7. doi: 10.1097/00007632-199301000-00014.
Ninety-six patients who had undergone first-time discectomy for herniated lumbar intervertebral discs were consecutively randomized to two physical rehabilitation programs: a program of high-intensity, dynamic back extension and abdominal exercises with occurrence of low back pain being the limiting factor or a traditional program of mild, generally mobility-improving exercises within pain limits. Both groups underwent 14 hours of treatment during a 6-week period 5 weeks after surgery. At 26 weeks' follow-up, results indicated that patients who did the high-intensity exercises experienced greater success with regard to the patient disability-index and work capabilities. After 1 year, a trend that favored the use of intensive exercises could be observed. No differences were found in pain or objective measurements. A rehabilitation program of intensive exercises with occurrence of back pain being the limiting factor appears to increase patient behavioral support, resulting in work capacity improvements and patient self-rated disability levels. The results indicate that a 6-wk, 14-hr postoperative rehabilitation program is inadequate if objective postoperative deficit improvements are the desired goal.
96例首次因腰椎间盘突出症接受椎间盘切除术的患者被连续随机分为两个物理康复项目组：一个是高强度动态背部伸展和腹部锻炼项目，以腰痛的出现作为限制因素；另一个是传统项目，即在疼痛限度内进行轻度的、通常能改善活动能力的锻炼。两组在术后5周的6周时间内均接受14小时的治疗。在26周的随访中，结果表明，进行高强度锻炼的患者在患者残疾指数和工作能力方面取得了更大的成功。1年后，可以观察到有利于采用强化锻炼的趋势。在疼痛或客观测量方面未发现差异。以腰痛的出现作为限制因素的强化锻炼康复项目似乎增加了患者行为支持，从而提高了工作能力和患者自评残疾水平。结果表明，如果期望术后客观缺陷得到改善，那么为期6周、14小时的术后康复项目是不够的。
