Effectiveness of a Visual Feedback Exercise Program Following Lumbar Surgery

Efficacy of Laser Pointer-Guided Visual Feedback Stabilization Exercise Program After Lumbar Microdiscectomy Surgery: A Randomized Controlled Trial

The aim of this study is to compare the effectiveness of stabilization exercises performed with visual feedback guided by a laser pointer after lumbar microdiscectomy surgery with that of standard stabilization exercises. The study, planned as a randomized controlled trial, will include 42 individuals aged 18-65 who have undergone lumbar microdiscectomy. Participants will be divided into two groups: a control group and a laser-guided exercise group. Both groups will undergo supervised stabilization exercises 3 days a week for 8 weeks, starting from the 6th postoperative week. The outcome measures were defined as pain, disability, back awareness, trunk muscle endurance, reaction time, balance, function, and lumbar proprioception. The findings are expected to demonstrate the effectiveness of visual feedback-assisted stabilization exercises in postoperative rehabilitation and contribute to clinical practice.

Study Overview

• Status: Recruiting
• Conditions: Randomized Controlled Trial; Postoperative Rehabilitation; Lumbar Microdiscectomy
• Intervention / Treatment: Other: Exercise; Other: Control

Detailed Description

This study is a randomized controlled trial designed to compare the effects of stabilization exercises performed with laser-guided visual feedback and conventional stabilization exercises in individuals who have undergone lumbar microdiscectomy surgery. A total of 42 participants aged 18-65 years who have undergone lumbar microdiscectomy will be included in the study. Participants will be randomly assigned to either a control group or a laser-guided exercise group. Both groups will receive supervised stabilization exercise programs three times per week for eight weeks, starting from the sixth postoperative week. The exercise content will be similar in both groups, with the laser-guided group receiving additional visual feedback during exercises. Outcome measures will be assessed at baseline and after completion of the intervention. Assessments will include pain, disability, back awareness, trunk muscle endurance, reaction time, balance, functional performance, and lumbar proprioception. The results of this study are expected to contribute to evidence-based postoperative rehabilitation approaches following lumbar microdiscectomy.

• Study Type: Interventional
• Enrollment (Estimated): 42
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: İsmet Tümtürk, MSc; Phone Number: +90 537 388 56 81; Email: fztismet@gmail.com

Study Locations

• Turkey (Türkiye)
  • Antalya, Turkey (Türkiye)
    • Recruiting
    • Antalya Provincal Health Directorate Antalya Training and Research Hospital
    • Contact: Cezmi Türk, Dr; Phone Number: +90 533 234 25 93; Email: cezmicagri.turk@sbu.edu.tr

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• To be between 18 and 65 years of age
• Patients who underwent lumbar microdiscectomy surgery
• Individuals who are literate in Turkish

Exclusion Criteria:

• Patients who have previously undergone lumbar disc herniation surgery
• The surgical procedure involving fusion has been performed.
• Having a body mass index above 30
• Suspected or confirmed tumors in the lumbar spine and spinal canal
• Severe heart failure and cerebrovascular accident
• The presence of cauda equina syndrome and concomitant diseases of the lumbar spine
• The presence of heart conditions, orthopedic contraindications, or systemic diseases that could prevent participation in the exercise program
• Refusing to participate in the study

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Laser-Guided Exercise Group; Participants received a supervised stabilization exercise program guided by visual feedback using a laser pointer, in addition to standard postoperative care following lumbar microdiscectomy surgery.	Other: Exercise; Participants undergo supervised stabilization exercises for a total of 24 sessions over 8 weeks, starting 6 weeks after lumbar microdiscectomy surgery, 3 days a week. The exercises will be performed with visual feedback provided by a laser pointer placed on the lumbar region. Participants will be asked to keep the laser pointer fixed on a designated point or line on the reference diagram in front of them during the exercises. The program includes posterior pelvic tilt, partial sit-ups, bird-dog, abdominal bracing in the supine position (progression with limb movements), straight and side planks, bridge building, pelvic floor, and diaphragmatic breathing exercises. Repetitive exercises will be performed in 3 sets of 10 repetitions, while plank exercises will initially be performed in 3 repetitions of 15-30 seconds, with progression based on the individual's performance and weeks. All participants will be provided with a post-operative training program in video format.; Other Names: Laser-Guided Supervised Exercise
Active Comparator: Control Group; Participants received a supervised stabilization exercise program without standard postoperative care, back training, or visual feedback following lumbar microdiscectomy surgery.	Other: Control; Starting 6 weeks after surgery, a supervised stabilization exercise program consisting of 24 sessions over 8 weeks, 3 days a week, will be implemented. The same exercises as in the laser group will be performed, but without the use of visual feedback. All participants will be provided with a post-operative training program in video format.; Other Names: Control Group

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain Assessment	It will be assessed using the Numerical Rating Scale (NRS).	All primary and secondary outcomes will be assessed at baseline (postoperative week 6) and post-intervention (postoperative week 14).
Disability Assessment	It will be measured using the Oswestry Disability Index (ODI).	All primary and secondary outcomes will be assessed at baseline (postoperative week 6) and post-intervention (postoperative week 14).
Lumbar Proprioception Assessment	It will be measured using a smartphone-based inclinometer application.	All primary and secondary outcomes will be assessed at baseline (postoperative week 6) and post-intervention (postoperative week 14).
Back Awareness Assessment	It will be assessed using the Fremantle Back Awareness Questionnaire.	All primary and secondary outcomes will be assessed at baseline (postoperative week 6) and post-intervention (postoperative week 14).

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Trunk Muscle Endurance Assessment	The McGill Endurance Tests will measure the endurance of the trunk flexor and lateral muscles.	All primary and secondary outcomes will be assessed at baseline (postoperative week 6) and post-intervention (postoperative week 14).
Lower Extremity Reaction Time Assessment	The motor response time to visual stimuli will be evaluated using the FITLIGHT® system.	All primary and secondary outcomes will be assessed at baseline (postoperative week 6) and post-intervention (postoperative week 14).
Balance Assessment	Static postural control will be measured using the one-leg stance test.	All primary and secondary outcomes will be assessed at baseline (postoperative week 6) and post-intervention (postoperative week 14).
Functional Performance Assessment	Functional mobility will be assessed using the timed up and go test.	All primary and secondary outcomes will be assessed at baseline (postoperative week 6) and post-intervention (postoperative week 14).

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Level of compliance with educational recommendations	Participants' level of compliance with the back training and daily life recommendations provided to them during the postoperative period will be assessed using a self-report form.	Postoperative week 6
Additional interventions	Participants will be asked whether they are receiving any other physical therapy, exercise program, or conservative treatment, and this information will be recorded.	Up to 8 weeks
Adverse event and adverse reaction monitoring	Any increase in pain, musculoskeletal complaints, or other potential adverse events that may occur during the exercise will be questioned and recorded during the sessions. Intervention will be terminated if necessary.	Up to 8 weeks
Drop-out and withdrawal reasons	The reasons for participants leaving the study (lack of motivation, health issues, incompatibility, etc.) will be documented and reported in the analyses.	Up to 8 weeks
Adherence to exercise sessions	The therapist will record participants' level of attendance at exercise sessions. Attendance at at least 80% of total sessions will be considered sufficient exercise compliance.	Post-intervention (postoperative week 14)
Sociodemographic and clinical characteristics	Gender	Post-operative day 1
Sociodemographic and clinical characteristics	Age (years)	Post-operative day 1
Sociodemographic and clinical characteristics	Body mass index (kg/m2)	Post-operative day 1

Collaborators and Investigators

• Sponsor: Suleyman Demirel University
• Investigators: Study Chair: İsmet Tümtürk, MSc, Suleyman Demirel University; Study Director: Ferdi Başkurt, PhD, Suleyman Demirel University; Principal Investigator: Cezmi Türk, Antalya Provincal Health Directorate Antalya Training and Research Hospital; Principal Investigator: Fatih Özden, Muğla Sıtkı Kocman University

Study record dates

Study Major Dates

• Study Start (Actual): January 16, 2026
• Primary Completion (Estimated): March 31, 2028
• Study Completion (Estimated): June 30, 2028

Study Registration Dates

• First Submitted: January 17, 2026
• First Submitted That Met QC Criteria: January 25, 2026
• First Posted (Actual): February 3, 2026

Study Record Updates

• Last Update Posted (Actual): February 3, 2026
• Last Update Submitted That Met QC Criteria: January 25, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena; Investigative Techniques; Epidemiologic Research Design; Epidemiologic Methods; Research Design; Methods; Exercise; Control Groups
• Other Study ID Numbers: Laser Pointer Exercise

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No