{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T22:33:05Z","timestamp":1793831585755,"version":"4.6.1"},"reference-count":71,"publisher":"Aboutscience Srl","issue":"1","license":[{"start":{"date-parts":[[2023,10,16]],"date-time":"2023-10-16T00:00:00Z","timestamp":1697414400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,10,16]],"date-time":"2023-10-16T00:00:00Z","timestamp":1697414400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Physiother"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>The role of rehabilitation after surgery in patients with low back pain is well recognized. The aim of this systematic review is to summarize and update the existing evidence according to the type of clinical condition and rehabilitation approach.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This systematic review included RCTs on the effectiveness of rehabilitation after surgery for lumbar disc herniation, spinal stenosis, and spondylolisthesis. We searched the literature for randomized controlled trials indexed in MEDLINE, Embase, CINHAL, CENTRAL, Scopus, PEDro, and Web of Science databases, up to April 15, 2023. We used Cochrane Risk of Bias 2.0 tool to assess each study. We conducted a quantitative synthesis when population, intervention, control, and outcome were sufficiently homogeneous; otherwise, we conducted a qualitative analysis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Forty-five studies (3.036 subjects) were included and analyzed according to the population considered: lumbar stenosis (1 trial), spondylolisthesis (3 trials), and disc herniation (41 trials). Regarding lumbar stenosis, a supervised active exercise program appears to improve outcomes related to pain, disability, and quality of life both in the short- and mid-term (1 study, <jats:italic>n<\/jats:italic>\u2009=\u200960). Concerning spondylolisthesis, kinesiophobia is reduced in the home exercises group compared to usual care, at 3-months follow-up (3 studies, <jats:italic>n<\/jats:italic>\u2009=\u200998). For disk herniation, supervised exercises are better than non-supervised exercises to reduce pain (MD -1.14; 95% CIs -1.65, -0.62; 5 trials, <jats:italic>n<\/jats:italic>\u2009=\u2009250) and disability (SMD -0.70; 95% CIs -1.14, -0.26; 4 trials, <jats:italic>n<\/jats:italic>\u2009=\u2009175). Supervised exercises are better than advice in reducing pain (SMD -0.91; 95% CIs -1.61, -0.21; 5 trials, <jats:italic>n<\/jats:italic>\u2009=\u2009341) and disability (SMD -0.80; 95% CIs -1.59, -0.01; 4 trials, <jats:italic>n<\/jats:italic>\u2009=\u2009261), in the short-term. Supervised exercises are equal to no treatment in reducing pain and disability, at 3 and 6\u00a0months after intervention (2 trials, <jats:italic>n<\/jats:italic>\u2009=\u2009166). These results are supported by a very low to low quality of evidence.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Our research suggests that supervised exercise may be effective in improving patient\u2019s pain and disability after lumbar surgery, but RCTs regarding lumbar spinal stenosis and lumbar spondylolisthesis are still scarce, with significant heterogeneity of proposed interventions.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40945-023-00175-4","type":"journal-article","created":{"date-parts":[[2023,10,16]],"date-time":"2023-10-16T11:02:57Z","timestamp":1697454177000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Rehabilitation after lumbar spine surgery in adults: a systematic review with meta-analysis"],"prefix":"10.33393","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6845-7427","authenticated-orcid":false,"given":"Tiziana","family":"Manni","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Ferri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Vanti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvano","family":"Ferrari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Cuoghi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Gaeta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Sgaravatti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Pillastrini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"18642","published-online":{"date-parts":[[2023,10,16]]},"reference":[{"issue":"4","key":"175_CR1","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1007\/s00586-018-5469-4","volume":"27","author":"AF Mannion","year":"2018","unstructured":"Mannion AF, Impellizzeri FM, Luenig M, Jeszenszy D, Becker HJ, Haschtmann D, Preiss S, Fehete TF. Time to remove our rose-tinted spectacles: a candid appraisal of the relative success of surgery in over 4500 patients with degenerative disorders of the lumbar spine, hip or knee. Eur Spine J. 2018;27(4):778\u201388.","journal-title":"Eur Spine J"},{"issue":"2","key":"175_CR2","doi-asserted-by":"crossref","first-page":"e209","DOI":"10.3928\/01477447-20160129-07","volume":"39","author":"S Pourtaheri","year":"2016","unstructured":"Pourtaheri S, Issa K, Lord E, Ajiboye R, Drysch A, Hwang K, Faloon M, Sinha K, Emami A. Paraspinal muscle atrophy after lumbar spine surgery. Orthopedics. 2016;39(2):e209\u201314.","journal-title":"Orthopedics"},{"issue":"10","key":"175_CR3","first-page":"1068","volume":"28","author":"A Hakkinen","year":"2003","unstructured":"Hakkinen A, Kuukkanen T, Tarvainen U, Ylinen J. Trunk muscle strength in flexion, extension, and axial rotation in patients managed with lumbar disc herniation surgery and in healthy control subjects. 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Is rehabilitation intervention during hospitalization enough for functional improvements in patients undergoing lumbar decompression surgery? a prospective randomized controlled study. Clin Neurol Neurosurg. 2015;129(Suppl 1):S41\u20136.","journal-title":"Clin Neurol Neurosurg"},{"issue":"3","key":"175_CR19","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1007\/s00586-016-4789-5","volume":"26","author":"O Ilves","year":"2017","unstructured":"Ilves O, H\u00e4kkinen A, Dekker J, Pekkanen L, Piitulainen K, J\u00e4rvenp\u00e4\u00e4 S, Marttinen I, Vihtonen K, Neva MH. Quality of life and disability: can they be improved by active postoperative rehabilitation after spinal fusion surgery in patients with spondylolisthesis? a randomised controlled trial with 12-month follow-up. 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