Effects of Exercise on Pain and Disability After Lumbar Disc Herniation Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Abstract

The aim of the study was to evaluate the effects of postoperative exercise on pain, disability, and quality of life after lumbar disc herniation surgery. We systematically searched the PubMed, Embase, Cochrane Library, and PEDro databases up to May 2024. Two reviewers independently selected and assessed relevant randomized controlled trials investigating the effectiveness of postoperative exercise after the surgical treatment of patients diagnosed with lumbar disc herniation on low back pain, disability, and quality of life assessed using visual analog scale, Oswestry Disability Index, and 36-item Short-Form Health Survey. Compared with the control group, the exercise intervention group had significantly lower visual analog scale scores both in the short-term (effect: 95% confidence interval = -1.14 [-1.69, -0.58], I 2 = 91.4%, n = 9 studies) and long-term follow-up (effect: 95% confidence interval = -0.99 [-1.89, -0.08], I 2 = 58.9%, n = 4 studies). The exercise intervention group also showed a significant reduction in Oswestry Disability Index in the short-term follow-up (effect: 95% confidence interval = -5.00 [-7.72, -2.29], I 2 = 79.3, n = 7 studies), but not in the long-term follow-up (effect: 95% confidence interval = -0.80 [-3.97, 2.38], I 2 = 0.0%, n = 4 studies). Among the Short-Form Health Survey factors, physical function, pain, general health, energy and vitality, and social function significantly improved in the exercise intervention group compared with the control group. Exercise after lumbar disc herniation surgery was effective in reducing pain and disability and improving quality of life.