The purpose of the present systematic review was to evaluate the effectiveness of exercise after lumbar decompression surgery on pain, function, motor-sensory symptoms, and psychosocial parameters.
A ...literature search was conducted with PubMed, Web of Science, Scopus, ScienceDirect, and Cochrane databases. Quality analysis and bias risk assessment were performed with “Physiotherapy Evidence Database” and “Revised Cochrane risk-of-bias tool randomized trials”, respectively. A total of 1219 articles were accessed from the relevant databases (PubMed = 97, Cochrane = 61, Web of Science = 97, Scopus = 104, ScienceDirect = 860). Fourteen studies were included in the systematic review. Systematic review results were presented with narrative synthesis due to heterogeneous data. Homogeneous data were given with meta-analysis.
The results demonstrated that strengthening, stabilization, and aerobic exercises provide additional advantages after lumbar decompression than education or clinical advice alone. Studies also emphasized the importance of relaxation, stretching, and mobilization training. The exercise training provided an additional advantage in terms of disability score at 6–12 weeks (short- to moderate-term) follow-up (effect size ES: −0.87, 95% confidence interval CI: −1.30; −0.45) with high-degree evidence. However, results in the identical pooling for pain scores showed low efficacy (ES: −0.35, 95% CI: −0.76; 0.05). Short Form-36 pooling in the 12-week follow-up demonstrated that exercise training had moderate-degree evidence effectiveness on physical function (ES: 0.51, 95% CI: 0.12; 0.91), bodily pain (ES: 0.52, 95% CI: 0.13; 0.91), and social function (ES: 0.53, 95% CI: 0.13; 0.93).
The results highlighted the importance of exercise training, particularly strengthening. Meta-analysis results also proved the effectiveness of exercise on disability in the short to medium term.
The aim of the study was to review the effect of exercise interventions in patients after lumbar fusion surgery. It was sought to reveal the effect of exercise protocols on various clinical ...parameters.
PubMed, Web of Science, Scopus, and ScienceDirect databases were searched. “Revised Cochrane risk-of-bias tool for randomized trials (ROB 2)” and “The Tool for the assEssment of Study qualiTy and reporting in EXercise (TESTEX)” were used to evaluate the bias risk and quality assessment, respectively.
A literature search yielded 1595 studies. After the procedures, eight and three studies were included in the systematic review and meta-analysis, respectively. TESTEX scores of the studies ranged from 4 to 10 (median: 7.50). The majority (n = 5) of the studies’ bias risk was classified as “some concerns” in ROB 2. The superiority of trunk-stabilization training was controlled in two studies. The most focused (n = 3) intervention was cognitive therapy plus exercise. Evidence proved that cognitive therapy plus exercise intervention was not superior to only exercise therapy on long-term pain (effect size ES: 0.48, 95% confidence interval CI: −0.44 to 1.47) and quality-of-life (ES: 1.34, 95% CI: −4.12 to 1.13) level. On the other hand, low-quality evidence demonstrated that cognitive therapy plus exercise yielded better results on long-term disability (ES: 0.78, 95% CI: −0.27 to 2.78) and kinesiophobia (ES: 0.14, 95% CI: 1.10 to 1.67).
The systematic review results demonstrated that cognitive therapy or consultation during the exercise program provides better outcomes in lumbar fusion surgery over exercise alone. Positive effects of core stabilization training on muscle strength and endurance were observed in the short term; however, this superiority was not the case in long-term studies. Meta-analysis results proved the positive effect of additional cognitive therapy to exercise on disability and kinesiophobia.
