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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:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Brief intervention only | Active Comparator | Brief intervention, an educational model, consists of information |
|
| Exercise group | Active Comparator | Brief educational intervention combined with exercise therapy |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Brief intervention, an educational model | Other | 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. |
| 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 |
| 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 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Kari Indrekvam, phd, MD | Helse Bergen HF, Haukeland University Hospital | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Haukeland University Hospital, Ortopedisk klinikk, Kysthospitalet i Hagevik | Bergen | Hordaland | Norway |
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| ID | Term |
|---|---|
| D011391 | Prolapse |
| D009043 | Motor Activity |
| ID | Term |
|---|---|
| D020763 | Pathological Conditions, Anatomical |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D001519 | Behavior |
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| ID | Term |
|---|---|
| D003419 | Crisis Intervention |
| D005081 | Exercise Therapy |
| ID | Term |
|---|---|
| D011613 | Psychotherapy |
| D004191 | Behavioral Disciplines and Activities |
| D012046 | Rehabilitation |
| D000359 | Aftercare |
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| Exercise therapy | Other | Patients are instructed to do prescribed exercises the first 3 months after surgery, and to log when they do these |
|
| 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 |
| D003266 |
| Continuity of Patient Care |
| D005791 | Patient Care |
| D013812 | Therapeutics |
| D026741 | Physical Therapy Modalities |