| Methods |
Patients were randomly assigned with stratification on sex and age (older than 40 years) before the operation |
| Participants |
212 patients after first‐time disc surgery performed for lumbar prolapse: operation that was usually carried out through an interlaminar trepanation and sequesters and any loose nucleus pulposus material was removed |
| Interventions |
Immediate postoperative care the same in both groups: out of bed day after surgery, two one‐hour health education lessons. (I) Start four weeks after surgery (N = 106): multifactorial rehabilitation (physiatrist, physical and occupational therapists, psychologist, social worker) for two weeks, "Intensive Back School". Encouraging physical activities. (C) Normal care: not described |
| Outcomes |
All numbers: one‐year follow‐up. Global perceived effect (five‐point scale). "Much better" or "Better": (I) 88%, (C) 83% not statically significant (NB: includes surgery!). Occupational handicap (WHO scales) and total sick leave during one‐year follow‐up period. No significant differences between groups. Reoperations: (I) 4/106, (C) 4/106: no difference |
| Notes |
|
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Random sequence generation (selection bias) |
Unclear risk |
Unclear from text |
| Allocation concealment (selection bias) |
Unclear risk |
Unclear from text |
| Blinding (performance bias and detection bias)
All outcomes ‐ patients? |
High risk |
Rehabilitation versus UC |
| Blinding (performance bias and detection bias)
All outcomes ‐ care providers? |
High risk |
Rehabilitation versus UC |
| Blinding (performance bias and detection bias)
All outcomes ‐ outcome assessors? |
High risk |
Participant reported |
| Incomplete outcome data (attrition bias)
All outcomes ‐ drop‐outs? |
Low risk |
Data on all participants reported |
| Incomplete outcome data (attrition bias)
All outcomes ‐ ITT analysis? |
Unclear risk |
Unclear from text |
| Selective reporting (reporting bias) |
High risk |
WHO scale handicap and sick leave, pain not reported |
| Similarity of baseline characteristics? |
Unclear risk |
Unclear from text |
| Co‐interventions avoided or similar? |
Unclear risk |
Unclear from text |
| Compliance acceptable? |
Unclear risk |
Unclear from text |
| Timing outcome assessments similar? |
Low risk |
One‐year follow‐up |
