Intensive, progressive exercise improves quality of life following lumbar microdiskectomy: a randomized controlled trial

Objective: The purpose of the study was to examine changes in quality of life measures in patients who have undergone an intensive exercise program following a single level microdiskectomy. Design: Randomized controlled trial with blinded examiners. Setting: The study was conducted in outpatient physical therapy clinics. Subjects: Ninety-eight participants (53 male, 45 female) who had undergone a single-level lumbar microdiskectomy allocated to receive exercise and education or education only. Interventions: A 12-week periodized exercise program of lumbar extensor strength and endurance training, and mat and upright therapeutic exercises was administered. Outcome measures: Quality of life was tested with the Short Form 36 (SF-36). Measurements were taken 4–6 weeks postsurgery and following completion of the 12-week intervention program. Since some participants selected physical therapy apart from the study, analyses were performed for both an as-randomized (two-group) design and an as-treated (three-group) design. Results: In the two-group analyses, exercise and education resulted in a greater increase in SF-36 scales, role physical (17.8 vs. 12.1) and bodily pain (13.4 vs. 8.4), and the physical component summary (13.2 vs. 8.9). In the three-group analyses, post-hoc comparisons showed exercise and education resulted in a greater increase in the SF-36 scales, physical function (10.4 vs. 5.6) and bodily pain (13.7 vs. 8.2), and the physical component summary (13.7 vs. 8.9) when compared with usual physical therapy. Conclusions: An intensive, progressive exercise program combined with education increases quality of life in patients who have recently undergone lumbar microdiskectomy.