Rehabilitation After Lumbar Disc Surgery: Exercise Therapy and Brief Educational Intervention

Rehabilitation after lumbar disc surgery (prolapse) focuses on various elements such as endurance, strength, stretching and information. Evidence concludes that it is not harmful to return to activity after lumbar disc surgery, and restrictions to activities after these operations are today more or less nonexistent. Some studies have shown that high intensity programs might be more effective, but they are probably more expensive. In recent years cognitive interventions have received more attention in rehabilitation programs after lumbar disc surgery. The cognitive approach is focused on providing patient knowledge to reduce uncertainty so that he or she can understand what is important after lumbar disc surgery so that belief in self-efficacy increases. A goal of the rehabilitation is to get the patient to resume normal activities. Reviews ask for how much treatment are needed in a rehabilitation program after lumbar disc surgery. The study will be a randomized clinical trial. The study will compare two different post-operative rehabilitation programs (general information or general information + exercise therapy). Both groups will begin treatment 1 day after surgery. Subjects in exercise therapy group are supposed to continue with exercises 3 months. In this study the following hypothesis will be studied: Brief intervention, an educational model, alone after lumbar disc surgery do have the same effect on pain in legs and low back as brief intervention, an educational model, combined with exercise therapy. Exercises which are instructed after lumbar disc surgery in a rehabilitation program, are being done by the patients.

The goal of the the brief intervention is to provide the patient knowledge to reduce uncertainty so that he or she can understand what is important after lumbar disc surgery so that belief in self-efficacy increases.

Patients are instructed to do prescribed exercises the first 3 months after surgery, and to log when they do these

Change from baseline in Fear-Avoidance Beliefs Questionnaire (physical activity) at 6-8 weeks and 1 year postsurgery

Inclusion Criteria: Diagnosed with lumbar disc prolapse with radicular pain Age between 18 and 60 Exclusion Criteria: Previous lumbar disc surgery (prolapse) Spondyloarthritis Arthritis Systematic disease Heart disease Does not understand Norwegian language, spoken or in writing