Summary of findings for the main comparison. Exercise therapy versus no treatment four to six weeks after lumbar disc surgery.
| Exercise compared with no treatment for patients after lumbar disc surgery | |||||
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Patient or population: patients four to six weeks after lumbar disc surgery Settings: primary care facilities and outpatient clinics Intervention: exercise Comparison: no treatment | |||||
| Outcomes | Illustrative comparative risks* (95% CI) | No. of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | ||||
| No treatment | Exercise | ||||
| Pain (post‐treatment) VAS or LBPRS Follow‐up: mean three months | Mean pain (post‐treatment) ranged across control groups from 3.25 to 42.9 VAS points or 12.13 LBPRS points | Mean pain (post‐treatment) in the intervention groups was 0.90 standard deviations lower (1.55 to 0.42 lower)1 | 272 (five studies) | ⊕⊝⊝⊝ very low2,3,4 | |
| Functional status (post‐treatment) ODI or LBPRS Follow‐up: mean three months | Mean functional status (post‐treatment) ranged across control groups from 15.1 to 23 ODI points or 10.95 LBPRS points |
Mean functional status (post‐treatment) in the intervention groups was 0.67 standard deviations lower (1.22 to 0.12 lower)5 | 252 (four studies) | ⊕⊕⊝⊝ low2,4 | |
| Functional status (long term) ODI or LBPRS Follow‐up: mean one year | Mean functional status (long term) ranged across control groups from 12 to 28 ODI points or 11.37 LBPRS points |
Mean functional status (long term) in the intervention groups was 0.22 standard deviations lower (0.49 lower to 0.04 higher)6 | 226 (three studies) | ⊕⊕⊝⊝ low2,4 | |
| CI: Confidence interval; VAS: Visual analogue scale; LBPRS: Low Back Pain Rating Scale; ODI: Oswesty Disabiliy Index | |||||
| Grades of evidence.
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate. No evidence: No RCTs were identified that addressed this outcome. | |||||
1Large effect size. 2Less than 75% of participants are from low risk of bias studies. 3Statistical inconsistency. 4Number of participants smaller than optimal information size. 5Medium effect size. 6Small effect size.