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April 2000 Volume 25, Number 8
Danielsen JM; Johnsen R; Kibsgaard SK; Hellevik E
Institute of Manual Therapy, Mo i Rana; the Institute of Community Medicine, University of Tromso, and Rana Hospital, Mo i Rana, Norway

Study Outcomes & Clinical Relevance: Vigorous medical exercise therapy, started 4 weeks after surgery for lumbar disc herniation, reduced disability and pain after surgery. Because no differences in clinical end points were observed, there is hardly any danger associated with early and vigorous training after operation for disc herniation.

As has been demonstrated again and again, active therapy prevails over passive or no therapy. In this study, surgery alone was insufficient to optimize outcomes, even when supplying patients with a few home exercises. Furthermore, several studies indicate spine patients (non-surgical and post-surgical) can tolerate very intensive conditioning programs. Given the present body of evidence, surgeons should be strongly encouraged to refer postoperative spine patients for supervised therapy by skilled professionals to ensure the best possible outcomes.