The effectiveness of physical exercise after lumbar fusion surgery: a systematic review and meta-analysis

. 2022 Apr 7;S1878-8750(22)00437-5.


doi: 10.1016/j.wneu.2022.03.143.


Online ahead of print.

Affiliations

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Fatih Özden.


World Neurosurg.


.

Abstract

The aim of the study was to review the effect of exercise interventions in patients after Lumbar Fusion Surgery (LFS). It was sought to reveal the effect of exercise protocols on various clinical parameters. PubMed, Web-of-Science, Scopus and ScienceDirect databases were searched. “Revised Cochrane (ROB2)” and “The Tool for the assEssment of Study qualiTy and reporting in EXercise (TESTEX)” were used to evaluate the bias risk and quality assessment, respectively. A literature search yielded 1595 studies. After the procedures, eight and three studies were included in the systematic review and meta-analysis, respectively. TESTEX scores of the studies were ranged from 4 to 10 (median:7.50). The majority (n=5) of the studies’ bias risk was classified as “some concerns” in ROB2. The superiority of trunk-stabilization training was controlled in two studies. The most focused (n=3) intervention was cognitive therapy plus exercise. Evidence proved that cognitive-therapy plus exercise intervention was not superior to only exercise therapy on long-term pain (ES:0.48,95%CI:-0.44-1.47) and quality-of-life (ES:1.34,95%CI:-4.12-1.13) level. On the other hand, low-quality evidence demonstrated that cognitive therapy plus exercise was yielded better results on long-term disability (ES:0.78,95%CI:-0.27-2.78) and kinesiophobia (ES: 0.14,95%CI:1.10-1.67). The systematic review results demonstrated that cognitive therapy or consultation during the exercise program provides better outcomes in LFS over exercise alone. Positive effects of core stabilization training on muscle strength and endurance were observed in the short term; however, this superiority was not the case in long-term studies. Meta-analysis results proved the positive effect of additional cognitive therapy to exercise on disability and kinesiophobia.


Keywords:

Exercise; physical therapy modalities; review; spinal fusion.

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