The quality of evidence is downgraded by imprecise results (few patients) and study limitations (differences in the control and intervention groups in the beginning of the studies).
A Cochrane review included 3 studies with a total of 373 subjects.
Outcomes in the short term (within six months postoperative). Active rehabilitation is more effective than usual care for functional status (log SMD -0.22, 95% CI -0.44 to 0.00, corresponding to an average percentage improvement (reduction in standardised functional score) of 20%, 95% CI 0% to 36%) and for reported low back pain (log MD -0.18, 95% CI -0.35 to -0.02, corresponding to an average percentage improvement (reduction in VAS score) of 16%, 95% CI 2% to 30%; 3 trials, 340 patients). In contrast, rehabilitation is no more effective than usual care for leg pain (log MD -0.17, 95% CI -0.52 to 0.19, corresponding to an average percentage improvement (reduction in VAS score) of 16%, 95% CI 21% worsening to 41%. Rehabilitation has no additional benefit on general health status as compared to usual care (MD 1.30, 95% CI -4.45 to 7.06; 2 trials, 238 patients).
Outcomes in the long term (at 12 months postoperative). Rehabilitation is more effective than usual care for functional status (log SMD -0.26, 95% CI -0.46 to -0.05, corresponding to an average percentage improvement (reduction in standardised functional score) of 23%, 95% CI 5% to 37%), for reported low back pain (log MD -0.20, 95% CI -0.36 to -0.05, corresponding to an average percentage improvement (reduction in VAS score) of 18%, 95% CI 5% to 30% and for leg pain (log MD -0.24, 95% CI -0.47 to -0.01, corresponding to an average percentage improvement (reduction in VAS score) of 21%, 95% CI 1% to 37%; 3 trials, 373 patients). Rehabilitation is no more effective than usual care with respect to improvement in general health (MD -0.48, 95% CI -6.41 to 5.4; 2 trials, 273 patients). Relevant adverse events were not reported.
Date of latest search: 2013-03-01