Physical therapies after surgery for lumbar disc herniation- evidence synthesis from 55 randomized controlled trials (RCTs) and a total of 4,311 patients

IF 1.9 Q3 CLINICAL NEUROLOGY
Alexandros G. Brotis , Adamantios Kalogeras , Theodosios Spiliotopoulos , Kostas N. Fountas , Andreas K. Demetriades
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引用次数: 0

Abstract

Introduction

The role of physical therapy after lumbar disc herniation surgery is unclear.

Research question

To determine the impact of physical therapy following LDH surgery (Q1), investigate the effects of activity limitations (Q2), the best time to start physical therapy (Q3), the significance of supervised physical rehabilitation (Q4), the types of physical therapies used (Q5), and the role of additional approaches, such as education, manipulation, and acupuncture, in enhancing the effectiveness of rehabilitation (Q6).

Material and methods

This systematic review searched three databases from inception to May 2024. Independent reviewers screened studies, assessed and extracted data, and critically appraised the quality of the available evidence.

Results

This systematic review included 55 randomized controlled trials with 4311 patients. We demonstrated that physical therapy after lumbar disc surgery is effective in alleviating pain and improving function and quality of life after surgery for lumbar disc herniation. Exercise regimens aimed at enhancing the endurance, flexibility, and strength of the back musculature are generally efficacious, with the exception of exercises involving neural mobilization. Imposing limitations on physical activity does not yield substantial advantages; however, the occurrence rate of potential complications, the optimal timing for initiating activity and the cost-effectiveness of supervised exercise remain subjects of ongoing discourse. Concurrent application of manual therapy, acupuncture, educational interventions, and behavioral and occupational therapy has the potential to augment outcomes.

Discussion and conclusion

Physical therapy improves functional outcomes after lumbar disc surgery. Further studies should address its safety, and cost-effectiveness, and provide dissemination and applicability tools.
腰椎间盘突出症手术后的物理疗法--55 项随机对照试验(RCT)和 4311 名患者的证据综述
引言腰椎间盘突出症手术后物理治疗的作用尚不明确。研究问题确定腰椎间盘突出症手术后物理治疗的影响(问题1),调查活动限制的影响(问题2),开始物理治疗的最佳时间(问题3),监督下物理康复的意义(问题4),使用的物理治疗类型(问题5),以及教育、手法和针灸等其他方法在提高康复效果方面的作用(问题6)。材料与方法本系统综述检索了从开始到 2024 年 5 月的三个数据库。独立审稿人筛选了各项研究,评估并提取了数据,对现有证据的质量进行了严格评估。我们证明,腰椎间盘手术后的物理治疗能有效减轻疼痛,改善腰椎间盘突出症手术后的功能和生活质量。旨在增强背部肌肉耐力、柔韧性和力量的锻炼方案一般都很有效,但涉及神经活动的锻炼除外。对体力活动施加限制并不会带来实质性的好处;然而,潜在并发症的发生率、开始活动的最佳时机以及指导性锻炼的成本效益仍是持续讨论的主题。同时应用徒手疗法、针灸、教育干预以及行为和职业疗法有可能提高疗效。进一步的研究应探讨其安全性和成本效益,并提供传播和应用工具。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Brain & spine
Brain & spine Surgery
CiteScore
1.10
自引率
0.00%
发文量
0
审稿时长
71 days
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