Table 1.
Summary of enrolled studies for rehabilitation treatment on patients after lumbar fusion surgery
| Study | Subjects and inclusion period | Orthopedic diseases | Rehabilitation | Outcome assessment of interest |
|---|---|---|---|---|
| Abbott [25] 2010 (Denmark) | 107 (66 females vs. 41 males) (50.7±10.4 years old), 3 sessions (90 min) between 0–3 months (postoperative) | Degenerative discdisease, spinal stenosis, degenerative/isthmic spondylolisthesis, spondylosis | CBT-related multimodal psychomotor therapy including CBT and graded motor relearning therapy (lumbopelvic stabiliza- tion) vs. home-based exercise program (dynamic exercises, stretches, cardiovascular) | 3 Months, 6 months, 1 year, 2 years, 3 years: disability (ODI), pain (VAS), pain-related fear, Euro- QoL Quality of Life Scale for quality of life, Short Form for Health Survery (SF-36) for mental health and Socioeconomic status scale, Brunnsviken Brief Quality of life scale, Tampa Scale of Kinesiophobia, work status |
| Christensen [26] 2003 (Denmark) | 90 (60 females vs. 30 males), median 47 years old, 16 postoperative sessions (90 min) during 8 weeks | Isthmic spondylolisthe- sis grades I to II, degeneration | Exercise rehabilitation (Exercise training (conditioning training, dynamic muscular endurance training (back/abdominal/leg muscles) and stretching) vs. video-recorded demonstration, with 1-time oral instruction, of exercises (dynamic muscular endurance training of back/abdominal/leg muscles) | 3, 6, 12, 24, Months; pain low back pain rating scale (leg, back, physical and emotional components), work status |
| Elsayyad [15] 2021 (Egypt) | 60 (35 females vs. 25 males), 42.05 ± 3.65 years old, visited the hospital 3 times per week for 4 weeks | Degenerative disc disease with or with- out spinal stenosis | Exercise rehabilitation (neural mobilization and stabilization exercise program; 12 to 15 minutes per session, including 30 seconds hold and 1 minute rest.) vs. stabilization exercise rehabilitation (hand, knee, leg dynamic training with Swiss ball balancing) | 1 Month and follow-up; disability (ODI), pain (VAS), right and left rotation, right and left lateral flexion, extension, flexion |
| Greenwood [19] 2019 (United Kingdom) | 52 (35 females vs. 27 males), 54.2 ± 13.5 years old, 10 sessions, starting 3 months (postopera- tive) | Degenerative disc disease, spinal steno- sis, isthmic spondylo- listhesis | Multimodal rehabilitation (peer support, education, exercise training (cardiovascular, limb and spine strengthening) vs. referral to external physiotherapy (no lifting heavier than a full kettle until 3 months) | 3, 6, 12 Months, disability (ODI) |
| He [14] 2021 (China) | 78 (40 females vs. 38 males), 51.29 ± 7.48 years old, day of surgery to postoperative 4 days | Lumbar degenerative disease lumbar disc herniation lumbar spinal stenosis, lum- bar spondylolisthesis. | A nurse-led early postoperative rehabilitation program combined with the importance of early postoperative rehabilitation exer- cises (breathing, bedside exercise, rehabilitation guidance) vs. routine care model (postoperative assessment of general condi- tion, postoperative guidance of patients’ eating, regular axial turning, absolute rest in a flat position) | 3rd day, 1 month disability (ODI), pain (VAS), Barthel index, compliance rate, complication rate |
| Ilves [12] 2022 (Finland) | 98 (72 females vs. 26 males), 59 ± 12 years old, 6 sessions between 3–15 months postoper- ative | Degenerative/ishmic spondylolisthesis | Exercise rehabilitation (progressive back specific exercise [control, coordination, strength, and endurance of back, abdominal, gluteal and thigh muscles], aerobic training) vs. single session guidance, independent training with no progression (abdomi- nal, [back and hip muscles], stretching and balance) | 3 Months, 12 months pain (VAS), strength, Schober, finger-tip to floor distance, lateral flexion, time-up and go test |
| Kernc [20] 2018 (Slovenia) | 27 (13 females vs. 14 males), 60.7 ± 7.9 years old, 18 sessions, during 9 weeks starting at 3rd week postoperative | Degenerative/ishmic spondylolisthesis; degenerative disc disease | Exercise rehabilitation (strength training [focus on lumbopelvic stabilization muscles, intra-abdominal pressure utilization]) vs. no exercises prior to 3 months postoperative | 3 Weeks, 3 months, 18 months: disability (ODI), pain (VAS), intra-abdominal pressure activation and performance |
| Lotzke [18] 2019 (Sweden) | 118 (63 females vs. 55 males), 45.7 ± 8.3 years old, 4 pre- (1 hr) and 1 postoperative (30 min) session | Disc herniation, foraminal stenosis, isthmic spondylolisthesis | CBT-related rehabilitation; multimodal (targeting psychological risk factors and promoting physical activity) vs. Referral to local physiotherapist (i.e., one preoperative session with core Exercise program, information and advice to stay active) | 1 Week preoperative; 3, 8, 12, 26 weeks postoperative: disability (ODI), pain (VAS), Tampa Scale of Kinesiophobia, Pain Catastrophizing Scale |
| Monticone [22] 2014 (Italy) | 130 (79 females vs. 51 males), 57.3 ± 13.1 years old, 8 postoperative sessions (1 hr) in 4 weeks | Spinal stenosis, degen- erative/isthmic spondylolisthesis | CBT-related rehabilitation (controlling catastrophizing, kinesio- phobia and maladaptive behavior) (in addition to control exer- cise condition) vs. hospital-based, physiotherapist-supervised exercise program, 5 times/wk during 4 weeks with active spinal mobilization and exercise training | 1 Month, 1 year posttreatment: pain-related fear, disability (ODI), pain (Numerical Rating Scale), Tampa Scale of Kinesiophobia |
| Nielsen [24] 2010 (Denmark) | 60 (35 females vs. 25 males), 50.1 years old, 2 preoperative sessions, 2 times/day mobiliza- tion postoperative | Degenerative disc disease | Exercise rehabilitation (home-based exercise program [strengthening back and abdomen muscle, cardiovascular] postoperative early mobilization [aim discharge on day 5] and exercise pro- gram) vs. postoperative mobilization once/day (aim discharge on day 8) | 2-Month preadmission, discharge, 1, 3, 6 months postoperative: disability (ODI), pain (VAS), Rolland-Morris Questionnaire |
| Oestergaard [16] 2020 (Denmark) | 82 (41 females vs. 41 males), 46.8 ± 8.8 years old, 1 pre- and volun- tary multiple postopera- tive sessions | Degenerative disc disease isthmic spondylolisthesis grades I to II | Multimodal rehabilitation (case-manager assisted rehabilitation program [preoperative meeting to determine rehabilitation program, postoperative (phone-) meeting] [in addition to control condition]) vs. rehabilitation unit-based, exercise program, 1–2 times/wk during 8–10 weeks, starting at 8th week after surgery | 3, 6, 9, 12, 24 Months: disability (ODI), pain (VAS), work status |
| Reichart [23] 2011 (Germany) | 39 (22 females vs. 17 males); 59.1 years old, 1 pre- and 1 postoperative session (30 min) | Spinal stenosis and instability | CBT-related rehabilitation (short psychological intervention fo- cusing on reducing fear-avoidance and motivational strategies) | 1st day, 6 weeks: pain-related fear, VAS, fear-avoidance beliefs questionnaire |
| Rolving [21] 2015 (Denmark) | 90 (51 females vs. 39 males); 50.1 ± 9.2 years old, 4 pre- and 2 post- operative sessions (3 hr) | Disc degenerative disease spondylolisthesis grades I to II | CBT-related Rehabilitation; multimodal (CBT covering interac- tion of cognition and pain perception, coping strategies, pacing principles, ergonomic directions, return to work and details about the surgical procedure [in addition to control condition]) vs. postoperative physiotherapist-supervised exercises in group or individual, starting 3 months after surgery | 1st week: Numeric Rating Scale 12 and 52nd week: disability (ODI), Low Back Pain Rating Scale, fear-avoidance beliefs questionnaire, work status 12 and 52 weeks |
| Salik [13] 2021 (Turkey) | 37 (19 females vs. 18 males); 53.9 years old, Daily for 6 weeks, start- ing 2nd day postoperative, 2 follow-up tele- phone calls | Spinal stenosis, degenerative/isthmic spondylolisthesis, disc degenerative disease with instability, spondylosis | Exercise rehabilitation; multimodal (home-based exercise pro- gram, each time preceded by motor imaginary exercises, facili- tated by voice commands) vs. home-based exercise program (education, neutral spine control, maximal voluntary isometric contraction), starting 2nd day postoperative | 3 and 6 weeks: disability (ODI), pain (VAS), Tampa Scale of Kinesiophobia |
| Strom [17] 2019 (Denmark) | 114 (74 females vs. 40 males), 54 years old, all-time access by web-based system | spondylolisthesis, degenerative disease | Multimodal rehabilitation (preoperative access to web-based system [web-based information/animation/diary/peer support, in line with CBT principles] [in addition to control condition]) vs. Physiotherapist-supervised exercise program, starting 3rd month postoperative | 2nd day, 3, 6 months: disability (ODI), Low Back Pain Rating Scale, EuroQoL Quality of Life Scale, Hamilton Rating Scale for Depression |
CBT, cognitive behavioral therapy; ODI, Oswestry Disability Index; VAS, visual analogue scale.