Rehabilitation Interventions for Postoperative Degenerative Lumbar Disease

Effects of Different Rehabilitation Interventions on Neuropathic Pain, Functional Recovery, and Quality of Life in Postoperative Patients With Degenerative Lumbar Disease: A Randomized Controlled Trial

The purpose of this study is to evaluate the effects of different rehabilitation interventions on patients who have undergone surgery for degenerative lumbar disease. The study focuses on assessing improvements in neuropathic pain, functional recovery, and overall quality of life. Participants will be randomly assigned to different rehabilitation programs to determine which approach provides the best outcomes for postoperative recovery.

Study Overview

• Status: Completed
• Conditions: Neuropathic Pain; Degenerative Lumbar Disease
• Intervention / Treatment: Behavioral: Stretching and Core Stability Exercise Program (Group A); Behavioral: Core Stability Exercise Program (Group B); Other: Standard Postoperative Nursing Care

• Study Type: Interventional
• Enrollment (Actual): 90
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Taiwan
  • Taiwan
    • Taipei, Taiwan, Taiwan, 100
      • National Taiwan University Hospital

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Patients diagnosed by a neurosurgeon with lumbar spinal stenosis, spondylolisthesis, or spondylosis involving L2-S1 segments, and scheduled for lumbar spine surgery.
• First-time recipients of lumbar spine surgery.
• Adults who are conscious and able to communicate effectively in Mandarin/Taiwanese (verbally or through writing).
• No history of psychiatric disorders.
• Willing to participate and sign the informed consent form.

Exclusion Criteria:

• Lower back pain caused by infection, inflammation, or malignancy (cancer).
• History of previous lumbar spine surgery.
• Patients with substance or drug addiction.
• Presence of psychiatric disorders.
• Unable to communicate effectively.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Experimental Group A: Stretching and Core Training; Participants receive a combination of stretching exercises and core stability training.	Behavioral: Stretching and Core Stability Exercise Program (Group A); A progressive postoperative rehabilitation program. Day 0: Ankle pumps and pelvic tilts (4 times/day, 5 reps). Day 1: Added heel slides, straight leg raises (SLR), and knee-to-chest stretches (4 times/day, 10 reps); walking to the bathroom (3 times/day). Day 2: Increased reps to 15; walking outside the room (5 mins, 3 times/day). Day 3: Increased reps to 20; increased walking time (10 mins, 3 times/day). Day 4 to Discharge: Continued exercises and increased walking. Post-discharge: Continued for at least 1 month.; Behavioral: Core Stability Exercise Program (Group B); Similar to Group A but without knee-to-chest stretches. Includes ankle pumps, pelvic tilts, heel slides, and SLR. The frequency and progression (reps and walking duration) are identical to Group A. Continued for at least 1 month post-discharge.
Experimental: Experimental Group B: Core Training; Participants receive core stability training only.	Behavioral: Core Stability Exercise Program (Group B); Similar to Group A but without knee-to-chest stretches. Includes ankle pumps, pelvic tilts, heel slides, and SLR. The frequency and progression (reps and walking duration) are identical to Group A. Continued for at least 1 month post-discharge.
Active Comparator: Control Group; Participants receive standard postoperative nursing care and education without specific exercise intervention.	Other: Standard Postoperative Nursing Care; Participants receive routine postoperative nursing care and standard health education provided by the neurosurgery ward.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change From Baseline in Taiwan Version of Neuropathic Pain Symptom Inventory (NPSI-T) Score	The NPSI-T evaluates 4 dimensions of neuropathic pain: spontaneous pain, paroxysmal pain, evoked pain, and dysesthesia. It consists of 18 items (including added items for cold pain, itching, and numbness). Each item is scored from 0 to 10. The total score ranges from 0 to 180, where a higher score indicates more severe neuropathic pain.	Baseline, 1 week, 2 weeks, 4 weeks, and 8 weeks post-surgery.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change From Baseline in Oswestry Disability Index (ODI) Version 2.1 Score	The ODI evaluates the impact of back pain on daily functional activities, including 10 items (pain intensity, personal care, lifting, walking, sitting, standing, sleeping, sex life, social life, and traveling). Each item is scored 0-5. The total score is converted to a percentage (0-100%). Scoring: 0-20% (minimal disability), 21-40% (moderate), 41-60% (severe), 61-80% (crippled), and 81-100% (bed-bound).	Baseline, 1 week, 2 weeks, 4 weeks, and 8 weeks post-surgery.
Change From Baseline in 12-item Short Form Health Survey (SF-12) Score	SF-12 measures health-related quality of life across physical (PCS) and mental (MCS) components. It consists of 12 items, and scores are transformed to a 0-100 scale. Higher scores indicate better physical and mental health status.	Baseline, 1 week, 2 weeks, 4 weeks, and 8 weeks post-surgery.
Change From Baseline in 50-foot Walk Test Time	Participants are asked to walk a 25-foot distance back and forth (total 50 feet/15 meters) as fast as possible without increasing pain. The time taken to complete the task is recorded in seconds using a stopwatch. A decrease in time indicates improvement in functional mobility.	Baseline, 1 week, 2 weeks, 4 weeks, and 8 weeks post-surgery.
Change From Baseline in Repeated Sit-to-Stand Test Time	Participants perform 5 consecutive sit-to-stand repetitions from a fixed-height chair as fast as possible. The time taken is recorded in seconds. A shorter duration indicates improved lower extremity strength and balance.	Baseline, 1 week, 2 weeks, 4 weeks, and 8 weeks post-surgery.

Collaborators and Investigators

• Sponsor: National Taiwan University Hospital
• Investigators: Study Chair: Kuei Fen Liu, RN, PhD, National Taiwan University Hospital

Study record dates

Study Major Dates

• Study Start (Actual): December 1, 2024
• Primary Completion (Actual): June 27, 2025
• Study Completion (Actual): August 27, 2025

Study Registration Dates

• First Submitted: April 12, 2026
• First Submitted That Met QC Criteria: April 19, 2026
• First Posted (Actual): April 24, 2026

Study Record Updates

• Last Update Posted (Actual): April 24, 2026
• Last Update Submitted That Met QC Criteria: April 19, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Rehabilitation; Quality of Life; Functional Recovery; Postoperative Recovery
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Nervous System Diseases; Neuromuscular Diseases; Peripheral Nervous System Diseases; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Neuralgia
• Other Study ID Numbers: 202404136RINB

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

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