Lumbar Disc Herniation, Radiculopathy
Conditions
Brief summary
The proposed study will be a randomized clinical trial designed to determine the most effective physical therapy program for individuals who have undergone lumbar discectomy surgery. The study will compare two different post-operative physical therapy programs (general strengthening or general + specific strengthening). Both groups will begin treatment 2 weeks post-surgery. Subjects in both groups will receive weekly treatment sessions for 8 weeks with a treatment program emphasizing exercises shown to activate the large trunk muscles without imposing potentially harmful compression or shear forces. The general + specific strengthening group will also receive exercises shown to isolate activation of the deep trunk muscles, in particular the multifidus, with training augmented by the use of diagnostic ultrasound biofeedback. Patient assessments will be conducted pre- and post-surgery, as well as 10 (post-treatment) and 26 weeks after surgery.
Interventions
OTHERRehabilitation following lumbar disc surgery (discectomy)
Exercise: walking, range of motion, and general trunk strengthening with or without specific trunk muscle motor control exercises.
Sponsors
University of Utah
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* 18-60 years old * Diagnosis of LDH based on imaging (MRI or CT scan) of the lumbar spine with concurring clinical examination findings (based on the judgment of the attending neurosurgeon) * Appropriate surgical candidate based on the opinion of the attending spine surgeon, and scheduled for single-level lumbar discectomy (open or micro-discectomy). * Able to attend weekly treatment sessions.
Exclusion criteria
* Prior surgery to the lumbar spine * Spondylolytic or degenerative spondylolisthesis present on pre-surgical imaging * Unable to speak and understand English * Peri- or post-operative complication (infection, nerve injury, dural tear, vascular injury, etc.) that would limit or delay the ability to participate in post-operative rehabilitation. * Multi-level surgery or the use of instrumentation during surgery (i.e., lumbar fusion)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Modified Oswestry disability index | Preoperative, 2 postoperative weeks, 10 postoperative weeks, 6 postoperative months |
Secondary
| Measure | Time frame |
|---|---|
| Lumbar multifidus muscle activation as estimated by diagnostic ultrasound imaging | preoperative, 2 postoperative weeks, 10 postoperative weeks, 6 postoperative months |
Countries
United States
Outcome results
None listed