Document Detail

Time courses of adaptation in lumbar extensor performance of patients with a single-level microdiscectomy during a physical therapy exercise program.
MedLine Citation:
PMID:  20479532     Owner:  NLM     Status:  MEDLINE    
STUDY DESIGN: Longitudinal single-cohort study. OBJECTIVE: To characterize the time course of performance adaptations during a postsurgical exercise intervention following a single-level microdiscectomy. BACKGROUND: Patients with a recent history of lumbar microdiscectomy are functionally limited, weak, have compromised paraspinal musculature, and benefit from an exercise program. METHODS: Patients (n = 48) with a single-level microdiscectomy participated in a 12-week (36 sessions) comprehensive strength and endurance exercise program starting 4 to 6 weeks postsurgery. Lumbar extensor strength was quantified as the degree from horizontal on a modified Sorensen test procedure. Patients unable to assume the horizontal position were assumed to have strength deficits. Lumbar muscular endurance performance was quantified by the amount of time patients could hold the Sorensen test position at the horizontal. The time rate of lumbar muscular endurance adaptations were analyzed using longitudinal growth curve modeling. RESULTS: The adherence rate of this program was low (67%). Twenty percent of the patients were identified as having strength deficits. These deficits were corrected in all patients within 3 to 9 weeks. Linear mixed-model results suggest an improvement of 5.6 seconds in hold time per week of exercise. Both the initial level of endurance and the rates of improvements were highly individualized. CONCLUSION: The time course of musculoskeletal performance adaptations in persons with a history of lumbar surgery is highly individualized. When compared to normative endurance times, the results of this study indicate that the number of sessions and duration of therapy needed to generate meaningful adaptations of the paraspinal musculature is longer than what is typically provided in the clinic postsurgery. LEVEL OF EVIDENCE: Therapy, level 4.J Orthop Sports Phys Ther 2010;40(6):336-344, Epub 13 May 2010. doi:10.2519/jospt.2010.3141.
Sean P Flanagan; Kornelia Kulig; Pt Clinresnet
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The Journal of orthopaedic and sports physical therapy     Volume:  40     ISSN:  0190-6011     ISO Abbreviation:  J Orthop Sports Phys Ther     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-15     Completed Date:  2010-08-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7908150     Medline TA:  J Orthop Sports Phys Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  336-44     Citation Subset:  IM    
California State University, Northridge, Department of Kinesiology, Northridge, CA 91330-8287, USA.
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MeSH Terms
Adaptation, Physiological*
Cohort Studies
Exercise Therapy / instrumentation,  methods*
Intervertebral Disk Displacement / surgery
Linear Models
Longitudinal Studies
Lumbar Vertebrae / surgery*
Middle Aged
Muscle Strength
Muscle Weakness / rehabilitation*
Physical Endurance
Postoperative Care

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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