Abstract
Physiotherapy after lumbar discectomy; an exploratory study of first-line health care
Objective. Nowadays, patients stay in hospital after lumbar disc surgery for a much shorter time than in the past, and rehabilitation is mainly the responsibilityof physiotherapists working in a primary care setting. The aim of this study was to learn more about indications for, and goals of, treatment and the underlying theoretical background of the treatment given.
Method. Twenty-seven primary care physiotherapy practices were asked to participate in the study. These practices treated patients who had undergone lumbar disc surgery in the University Medical Center Groningen. Twenty-five physiotherapists completed a semistructured interview.
Results. Physiotherapy mainly consisted of exercise or training. The treatments provided were based on three theoretical concepts. In group 1 the main focus was on avoiding high lumbar disc loads, with emphasis on increasing muscular stability, adopting a ’good’ posture, and moving without restrictions. In group 2 the focus was on muscular stability and exercising without restrictions, and in group 3 the focus was on active movements without specific restrictions.
Conclusion. Different physiotherapy treatments are used to help patients recover from lumbar disc surgery. These treatments have different theoretical backgrounds and differ in the type of exercises, education, and restrictions. As a consequence of these differences, hospitals should consider referring patients to physiotherapy practices that provide the treatment that is most compatible with the hospital’s perceived treatment goals. A randomized trail should be performed to analyse the consequences of these different treatment approaches for patients.