Effects of rehabilitation and behavior change interventions on physical capacity and physical activity behavior following lumbar surgery for degenerative disease: A systematic review and meta-analysis.

Study Summary

30 randomized controlled trials including 2527 patients with lumbar degenerative disease were included in this systematic review. Comparisons included exercise vs minimal or usual care, supervised vs self-directed exercise, psychologically informed rehabilitation vs minimal or usual care, physical activity advice vs minimal or usual care, and prehabilitation vs minimal or usual care. Pooled outcomes included trunk extension endurance and physical activity levels across immediate and intermediate follow-up. Supervised exercise improved immediate trunk extension endurance, while psychologically informed rehabilitation and prehabilitation produced small intermediate-term improvements in physical activity. Physical activity advice alone did not improve activity levels. Overall, structured and supervised rehabilitation may improve early physical capacity, while more comprehensive behavioural interventions may be needed to change physical activity over time.