Evaluation of the Back Muscle Exercise for the Lumbar Discectomy Patients

Dae-Ho Ha; Tae-Kyun Kim; Dae-Moo Shim; Chang-Su Kim; Taehun Kim; Da-Hee Kim

doi:10.4184/jkss.2013.20.4.143

Journal List > J Korean Soc Spine Surg > v.20(4) > 1075994

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Ha, Kim, Shim, Kim, Kim, and Kim: Evaluation of the Back Muscle Exercise for the Lumbar Discectomy Patients

Original Article

Journal of Korean Spine Surg 2013;20(4):143-148.

Published online: 21 December 2013

DOI: https://doi.org/10.4184/jkss.2013.20.4.143

Evaluation of the Back Muscle Exercise for the Lumbar Discectomy Patients

Dae-Ho Ha, M.D.^∗, Tae-Kyun Kim, M.D.^∗,, Dae-Moo Shim, M.D.^∗, Chang-Su Kim, M.D.^†, Taehun Kim, M.D.^†, Da-Hee Kim, P.T.^∗

^∗Department of Orthopedic Surgery, School of Medicine, Wonkwang University, Iksan, Korea

^†Department of Orthopedic Surgery, School of Medicine, Kosin University Gospel Hospital, Busan, Korea

Corresponding author: Tae-Kyun Kim, M.D. Department of Orthopedic Surgery, School of Medicine, Wonkwang Universiy, Wongwang Medical Center, Sinyong-dong, Iksan-si, Jeollabuk-do, Korea TEL: 82-63-859-1360, FAX: 82-63-852-9329 E-mail: osktg@wonkwang.ac.kr

Received 9 October 2012 Revised 12 November 2012 Accepted 23 October 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Study Design

Retrospective study.

Objectives

To identify the implementation of self-exercise therapy and analyze the effects of exercise therapy after lumbar discectomy

Materials and Methods

Studied 47 patients who underwent partial lumbar discectomy and laminectomy from January, 2009 to December, 2009. They were instructed on 16 kinds of exercise therapy in total from postoperative 1day to postoperative 6weeks. Group A (n=25), whose frequency of outpatient clinic visit is above the average, and Group B (n=22), whose frequency of visit is relatively low;, below 5 times. We tested the visual analog scale (VAS scale) of back, Oswestry disability index and the strength of the two groups before surgery and at postoperative 3, 6, and 12 months.

Results

The degree of pain was significantly different (26.6±9.4 and 53.5±18.6) between group A and group B at postoperative 6 months. Function of daily life and strength test were significantly different (6.6±4.8 and 11.3±4.0 at group A, 3.6±0.9 and 3.0±1.1 at group B) between the two groups at postoperative 12 months. The characteristics of low compliance patients are low accessibility to the hospital and lack of knowledge on the importance of exercise according to the degree of pain.

Conclusion

These results suggested that postoperative exercise program has significant effects on the pain, the function of daily life. It also increases flexibility and strengthens the muscle of patients with high compliance of outpatient clinic visit. The factors influencing the results are the age of patients, the willingness to exercise, and the environment in which each patient lives/resides.

Keywords: Lumbar discectomy, Postoperative back muscle exercise, Outpatient clinic

REFERENCES

1. Choi G, Raiturker PP, Kim MJ, Chung DJ, Chae YS, Lee SH. The effect of early isolated lumbar extension exercise program for patients with herniated disc undergoing lumbar discectomy. Neurosurgery. 2005; 57:764–72.

2. Ostelo RW, de Vet HC, Waddell G, Kerckhoffs MR, Lef-fers P, van Tulder M. Rehabilitation following first-time lumbar disc surgery: a systematic review within the frame-work of The Cochrane Collaboration. Spine (Phila Pa 1976). 2003; 28:209–18.

3. Lee DH, Shim DM, Kim SS, Ha DH, Kim TK, Kim YJ, Song HH, Kwon SH. Effects of the strengthening exercise on back muscles after lumbar discectomy. J Korean Soc Spine Surg. 2002; 9:41–7.

4. Johansson AC, Linton SJ, Berqkvist L, Nilsson O, Corne-fjord M. Clinic-based training in comparison to homebased training after first-time lumbar disc surgery: a ran-domised controlled trial. Eur Spine J. 2009; 18:398–409.

5. Dolan P, Greenfield K, Nelson RJ, Nelson IW. Can exercise therapy improve the outcome of microdiscectomy? Spine (Phila Pa 1976). 2000; 25:1523–32.

6. Fairbank JC, Couper J, Davies JB, O'Brien JP. The Oswestry low back pain disability questionnaire. Physiotherapy. 1980; 66:271–3.

7. Ito T, Shirado O, Suzuki H, Takahashi M, Kaneda K, Strax TE. Lumbar trunk muscle endurance testing: an inexpen-sive alternative to a machine for evaluation. Arch Phys Med Rehabil. 1996; 77:75–9.

8. Moffroid MT. Endurance of trunk muscles in persons with chronic low back pain: assessment, performance, training. J Rehabil Res Dev. 1997; 34:440–7.

9. Hä kkinen A, Ylinen J, Kautiainen H, Tarvainen U, Kiviranta I. Effects of home strength training and stretching versus stretching alone after lumbar disk surgery: a randomized study with a 1-year followup. Arch Phys Med Rehabil. 2005; 86:865–70.

10. Danielsen JM, Johnsen R, Kibsgaard SK, Hellevik E. Early aggressive exercise for postoperative rehabilitation after discectomy. Spine (Phila Pa 1976). 2000; 25:1015–20.

11. Hansen FR, Bendix T, Skov P, Jensen CV, Kristensen JH, Krohn L, Schioeler H. Intensive, dynamic back-muscle exercises, conventional physiotherapy, or placebo-control treatment of low-back pain: a randomized, observer-blind trial. Spine (Phila Pa 1976). 1993; 18:98–108.

12. Feldwieser FM, Sheeran L, Meana-Esteban A, Sparkes V. Electromyographic analysis of trunk-muscle activity during stable, unstable and unilateral bridging exercises in healthy individuals. Eur Spine J. 2012; 21:171–86.

13. Rasmussen-Barr E, Ä ng B, Arvidsson I, Nilsson-Wikmar L. Graded exercise for recurrent low-back pain: a randomized, controlled trial with 6-, 12-, and 36-month followups. Spine. 2009; 34:221–8.

14. Ostelo R. Rehabilitation following lumbar disc surgery. J Evidence‐Based Med. 2009; 2:130–1.

Table 1.

Summary of Exercise Starting Time and Method

Session	Exercise
Post OP 1 day	Prone Position, Deep Abdominal Contraction Upper Extremity Strengthening
Post OP 2 Week	Back Extension, Straight Leg Raise Hip Extension, Abdominal Strengthening
Post OP 4 Week	Ankle & Toe Raise, Knee To Chest, Hip Abduction / Adduction Treadmill, Bicycle, Dumbell
Post OP 6 Week	Balance Exercise, Gym-Ball

Table 2.

Patients Demographic Characteristics.

	Demographics	Group A(n=25)	Group B(n=22)	p-value
Age (yr)		53.4	52.1	0.27
BMI	>27	7	5	0.91
	≤26	18	17
Gender	female	11	10	0.12
	male	14	12
Working status	Full time	6	2	0.15
	Part time	5	4
	None	10	7
	Others	4	9
Alcohol	Yes	13	14	0.72
	None	12	8
Smoking	Yes	16	12	0.09
	None	9	10
P<0.05

Table 3.

The Result of Visual Analog Scale (VAS) of back.

GROUP	Group A (n=25)	GroupB (n=22)	p-value
Baseline	73.1±19.0	79.5±18.1	0.205
Post 3month	52.6±16.6	49.0±19.0	0.456
Post 6month	26.6±9.4	53.5±18.6	*0.025
Post 12month	12.5±9.9	28.9±11.5	*0.019

Values are mean±S.D. *p<0.05

Table 4.

The Result of Oswesrty Disability Index (Total : 50 points)

GROUP	Group A (n=25)	GroupB (n=22)	p-value
Baseline	27.4±9.1	24.6±8.3	0.238
Post 12 month	6.6±4.8	11.3±4.0	*0.042

Values are mean±S.D.

Table 5.

The Result of Muscle Test.

GROUP	Group A (n=25)	GroupB (n=22)	p-value
Baseline	1.8±0.6	1.6±0.6	0.331
Post 3 month	2.1±0.4	1.9±0.5	*0.012
Post 6 month	2.6±0.7	2.3±0.5	0.091
Post 12 month	3.6±0.9	3.0±1.1	*0.019

Values are mean *p<0.05

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