12 anni di follow-up su uno studio sulla fisioterapia dopo intervento di ernia del disco

Dopo 12 anni al follow-up i pazienti che hanno seguito un programma di fisioterapia in seguito ad intervento di ernia del disco hanno risultati funzionali migliori.
Clin Rehabil. 2015 Jun;29(6):548-60. doi: 10.1177/0269215514552032. Epub 2014 Oct 6.

Twelve-year follow-up of a randomized controlled trial of comprehensive physiotherapy following disc herniation operation.

Ebenbichler GR1, Inschlag S2, Pflüger V3, Stemberger R3, Wiesinger G4, Novak K5, Christoph K6, Resch KL7.

Author information

  • 1Department of Physical Medicine & Rehabilitation, Vienna Medical University, Vienna, Austria Gerold.Ebenbichler@meduniwien.ac.at.
  • 2Vienna Medical University, Vienna, Austria.
  • 3Department of Physical Medicine & Rehabilitation, Vienna Medical University, Vienna, Austria.
  • 4Physical of Medicine & Rehabilitation, Salzburg Medical University, Salzburg, Austria.
  • 5Department of Neurosurgery, Medical University of Vienna, Vienna, Austria.
  • 6Section of Medical Statistics, Medical University of Vienna, Vienna, Austria.
  • 7German Institute of Health Research, Bad Elster and Dresden, Germany.

Abstract

OBJECTIVE:

To evaluate the long-term effects of postoperative comprehensive physiotherapy starting one week after lumbar disc surgery.

DESIGN:

Twelve-year follow-up of a three-armed, randomized, controlled, single-blinded clinical trial.

SETTING:

Department of Physical Medicine & Rehabilitation.

PARTICIPANTS:

Of 111 patients following first-time, uncomplicated lumbar disc surgery who participated in the original study and completed the treatment originally allocated, 74 ((67%; 29 (73%) physiotherapy, 22 (58%) sham therapy, 23 (68%) no therapy) completed a 12-year follow-up examination.

INTERVENTIONS:

In the original study, patients had been randomly assigned to comprehensive physiotherapy, sham intervention (neck massage), or no therapy.

MEASURES:

Low Back Pain Rating Scale; best score 0, worst score 130 points).

RESULTS:

At 12 years after surgery, the group participating in comprehensive physiotherapy had significantly better functional outcomes, as rated on the Low Back Pain Rating Score, than the untreated group (mean difference: -13.2 (95% CI: (-25.4; -1.0)). Equally, there was a clinically relevant, non-significant difference between the sham therapy and no therapy (mean difference: -12.5 (95%CI: -26.1; 1.1)). Consequently, the Low Back Pain Rating Score outcome did not differ between physiotherapy and sham therapy (mean difference: -0.7 (95%CI: -14.2; 12.8)).

CONCLUSIONS:

Participating in a comprehensive physiotherapy program following lumbar disc surgery may be associated with better long-term health benefits over no intervention, but may not be superior to sham therapy.