| Methods |
Randomised by minimisation and stratified for sex, age (cutoff 40 years) ± preoperative hospitalisation ± postoperative complications |
| Participants |
40 patients undergoing a first lumbar discectomy (L4‐L5) for classic nerve root compression symptoms without cauda equina and confirmatory imaging; at least two weeks of unsuccessful conservative therapy; aged between 18 and 65 years, employed were included. Excluded: specific other diseases of spine or hip or system diseases. Interventions start within four to six weeks after surgery |
| Interventions |
(I) (N = 20) supervised group training (max 10 participants) one hour twice a week for three months. Session: 10 minutes warming up bicycle, dynamic exercises (endurance) for low and high back, buttock and abdominal muscles supervised by PT. (C) (N = 20) individual training at home with two hours of instruction by PT plus written instructions. Same exercises as (I) |
| Outcomes |
Back pain (five‐point scale): T0, three, six months; median and 12.5 percentiles: (I): 4.1 (2.5 to 6.0), 2.8 (1.8 to 4.8), 2.8 (1.8 to 4.2), (C) 4.0 (2.0 to 5.9), 2.4 (1.7 to 4.2), 2.5 (1.8 to 5.8) Global Perceived Effect (four‐point scale, 0 = good, 3 = bad): (I) 1.6 (0.8 to 2.5), 1.1 (0.7 to 1.9), 1.0 (0.6 to 1.5), (C) 1.4 (0.7 to 2.2), 1.2 (0.7 to 2.0), 1.3 (0.7 to 2.9). No differences except extension strength at three months for (C). ROM (sum‐score in cm) (I): 12 (‐3 to 26), 26 (19 to 41), 27 (8 to 37), (C) 16 (2 to 29), 23 (17 to 30), 26 (15 to 41). Disability (12‐point scale with 12 = maximum disability) (I) 3 (0 to 4), 0 (0 to 2), 0 (0 to 3), (C) 2 (0 to 5), 0 (0 to 2), 0 (0 to 2) (NS). Isokinetic trunk extension strength: (I) 36 (13 to 48), 45 (23 to 57), 50 (34 to 77), (C) 47 (12 to 59), 54 (35 to 69), 64 (45 to 73). |
| Notes |
|
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Random sequence generation (selection bias) |
Low risk |
Randomised by minimisation and stratified for sex |
| Allocation concealment (selection bias) |
Low risk |
Personal communication |
| Blinding (performance bias and detection bias)
All outcomes ‐ patients? |
High risk |
Supervised versus home exercises |
| Blinding (performance bias and detection bias)
All outcomes ‐ care providers? |
High risk |
Supervised versus home exercises |
| Blinding (performance bias and detection bias)
All outcomes ‐ outcome assessors? |
High risk |
Patient reported |
| Incomplete outcome data (attrition bias)
All outcomes ‐ drop‐outs? |
High risk |
Nine/20 = 45% and four/20 = 20% dropouts |
| Incomplete outcome data (attrition bias)
All outcomes ‐ ITT analysis? |
High risk |
Dropouts |
| Selective reporting (reporting bias) |
Low risk |
Pain and function in methods, reported in Table 2 |
| Similarity of baseline characteristics? |
Unclear risk |
Unclear, baseline dropouts not reported |
| Co‐interventions avoided or similar? |
Unclear risk |
Unclear from text |
| Compliance acceptable? |
Unclear risk |
Unclear from text |
| Timing outcome assessments similar? |
Low risk |
Three, six months |
