Effectiveness of the Out-Patient Rehabilitation and Home Exercise Program to the Patients with Lumbar Disc Herniation

Abstract

In scientific literature there are few studies dealing with the effectiveness of home exercise program in patients with low back pain. These issues are very important since the out-patient institutions provide just temporal and short-term physical therapy. Patients having gone through it are left without the supervision of physical therapist and depend only on the effectiveness of home exercise program. There is also lack of studies in which the effectiveness of out-patient treatment and home exercise program is compared. The aim of the study was to assess the effectiveness of the out-patient rehabilitation and home exercise program for patients with lumbar disc herniation. Contingent: there were 60 patients from 20 to 60 years of age (average age 40.7 ± 2.2) investigated, 27 women and 33 men. The patients with strong low back pain had been treated in the Department of Vertebroneurology and in the Department of Physical Medicine and Rehabilitation of Kaunas Clinical Hospital. All the patients were diagnosed with the intervertebral disc herniation, no surgical treatment was applied before. After in-patient rehabilitation one group was pointed to the out-patient rehabilitation (30 patients), the second group participated in home treatment (30 patients, too). This group was called home exercise program group. These patients were motivated to do exercises 14 days, once a day at home and agreed to participate in home rehabilitation program. Home exercise program for these patients was composed. Methods of the investigation: low back pain (using numerical analogue pain scale), the level of functional disability (using RolandMorris questionnaire) and the quality of life (EQ-5D questionnaire) before and after treatment were evaluated.
Results: after out-patient rehabilitation, low back pain and functional disability decreased and the quality of life increased more than after home exercise program. Conclusion: 1. After out-patient rehabilitation, low back pain and the level of functional disability decreased and the quality of live increased more than after home exercise program. 2. Home exercise program reduced low back pain and the level of functional disability, but it did not change the quality of life (p > 0.05). Practical recommendation: low back pain, the level of functional disability decreased and quality of life after out-patient rehabilitation improved more in comparison to those patients, who applied home exercise program and it is recommended to continue out-patient rehabilitation after in-patient treatment.

Keywords: low back pain, intervertebral disc herniation, out-patient rehabilitation, home exercise program.