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

Study Overview
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Brief Summary
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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.

Official Title
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Rehabilitation After Lumbar Surgery

Conditions
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Prolapse

Intervention / Treatment
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* Other: Brief intervention, an educational model
* Other: Exercise therapy


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Brief intervention only<br>Brief intervention, an educational model, consists of information | Other: Brief intervention, an educational model<br>* 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.<br>|
| Active Comparator: Exercise group<br>Brief educational intervention combined with exercise therapy | Other: Brief intervention, an educational model<br>* 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.<br>Other: Exercise therapy<br>* Patients are instructed to do prescribed exercises the first 3 months after surgery, and to log when they do these<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline in pain in the low back and the legs at 6-8 weeks and 1 year postsurgery |  | Baseline, 6-8 weeks postsurgery and 1 year postsurgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Disability and beliefs about the condition |  | Baseline, 6-8 weeks postsurgery and 1 year postsurgery | 
| Change from baseline in Oswestry Disability Index at 6-8 weeks and 1 year postsurgery |  | Baseline, 6-8 weeks postsurgery and 1 year postsurgery | 
| Change from baseline in Tampa scale of Kinesiophobia (TSK-13) at 6-8 weeks and 1 year postsurgery |  | Baseline, 6-8 weeks postsurgery and 1 year postsurgery | 
| Change from baseline in Fear-Avoidance Beliefs Questionnaire (physical activity) at 6-8 weeks and 1 year postsurgery |  | Baseline, 6-8 weeks postsurgery and 1 year postsurgery | 
| Change from baseline in anticipation to return to work at 6-8 weeks postsurgery |  | Baseline and 6-8 weeks postsurgery postsurgery | 
| Change from baseline in health condition at 6-8 weeks and 1 year postsurgery |  | Baseline, 6-8 weeks postsurgery and 1 year postsurgery | 
| Change from baseline in health condition rating at 6-8 weeks and 1 year postsurgery |  | Baseline, 6-8 weeks postsurgery and 1 year postsurgery | 
| Recidive prolapse |  | 1 year postsurgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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rehabilitation,surgery,brief intervention, exercises