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The purpose of this study is to evaluate the effects of different rehabilitation interventions on patients who have undergone surgery for degenerative lumbar disease. The study focuses on assessing improvements in neuropathic pain, functional recovery, and overall quality of life. Participants will be randomly assigned to different rehabilitation programs to determine which approach provides the best outcomes for postoperative recovery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Experimental Group A: Stretching and Core Training | Experimental | Participants receive a combination of stretching exercises and core stability training. |
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| Experimental Group B: Core Training | Experimental | Participants receive core stability training only. |
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| Control Group | Active Comparator | Participants receive standard postoperative nursing care and education without specific exercise intervention. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Stretching and Core Stability Exercise Program (Group A) | Behavioral | A progressive postoperative rehabilitation program. Day 0: Ankle pumps and pelvic tilts (4 times/day, 5 reps). Day 1: Added heel slides, straight leg raises (SLR), and knee-to-chest stretches (4 times/day, 10 reps); walking to the bathroom (3 times/day). Day 2: Increased reps to 15; walking outside the room (5 mins, 3 times/day). Day 3: Increased reps to 20; increased walking time (10 mins, 3 times/day). Day 4 to Discharge: Continued exercises and increased walking. Post-discharge: Continued for at least 1 month. |
| Measure | Description | Time Frame |
|---|---|---|
| Change From Baseline in Taiwan Version of Neuropathic Pain Symptom Inventory (NPSI-T) Score | The NPSI-T evaluates 4 dimensions of neuropathic pain: spontaneous pain, paroxysmal pain, evoked pain, and dysesthesia. It consists of 18 items (including added items for cold pain, itching, and numbness). Each item is scored from 0 to 10. The total score ranges from 0 to 180, where a higher score indicates more severe neuropathic pain. | Baseline, 1 week, 2 weeks, 4 weeks, and 8 weeks post-surgery. |
| Measure | Description | Time Frame |
|---|---|---|
| Change From Baseline in Oswestry Disability Index (ODI) Version 2.1 Score | The ODI evaluates the impact of back pain on daily functional activities, including 10 items (pain intensity, personal care, lifting, walking, sitting, standing, sleeping, sex life, social life, and traveling). Each item is scored 0-5. The total score is converted to a percentage (0-100%). Scoring: 0-20% (minimal disability), 21-40% (moderate), 41-60% (severe), 61-80% (crippled), and 81-100% (bed-bound). |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Kuei Fen Liu, RN, PhD | National Taiwan University Hospital | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| National Taiwan University Hospital | Taipei | Taiwan | 100 | Taiwan |
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Participants were informed that they would be assigned to one of different postoperative rehabilitation programs but were not told the specific differences between the exercise protocols.
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| Core Stability Exercise Program (Group B) | Behavioral | Similar to Group A but without knee-to-chest stretches. Includes ankle pumps, pelvic tilts, heel slides, and SLR. The frequency and progression (reps and walking duration) are identical to Group A. Continued for at least 1 month post-discharge. |
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| Standard Postoperative Nursing Care | Other | Participants receive routine postoperative nursing care and standard health education provided by the neurosurgery ward. |
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| Baseline, 1 week, 2 weeks, 4 weeks, and 8 weeks post-surgery. |
| Change From Baseline in 12-item Short Form Health Survey (SF-12) Score | SF-12 measures health-related quality of life across physical (PCS) and mental (MCS) components. It consists of 12 items, and scores are transformed to a 0-100 scale. Higher scores indicate better physical and mental health status. | Baseline, 1 week, 2 weeks, 4 weeks, and 8 weeks post-surgery. |
| Change From Baseline in 50-foot Walk Test Time | Participants are asked to walk a 25-foot distance back and forth (total 50 feet/15 meters) as fast as possible without increasing pain. The time taken to complete the task is recorded in seconds using a stopwatch. A decrease in time indicates improvement in functional mobility. | Baseline, 1 week, 2 weeks, 4 weeks, and 8 weeks post-surgery. |
| Change From Baseline in Repeated Sit-to-Stand Test Time | Participants perform 5 consecutive sit-to-stand repetitions from a fixed-height chair as fast as possible. The time taken is recorded in seconds. A shorter duration indicates improved lower extremity strength and balance. | Baseline, 1 week, 2 weeks, 4 weeks, and 8 weeks post-surgery. |
| ID | Term |
|---|---|
| D009437 | Neuralgia |
| ID | Term |
|---|---|
| D010523 | Peripheral Nervous System Diseases |
| D009468 | Neuromuscular Diseases |
| D009422 | Nervous System Diseases |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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