The effect of exercise in the treatment of lumbar disc herniation: a systematic review

Background

Systematic review explores the scientific evidence for the effectiveness of exercise interventions for lumbar disc herniation (LDH). LBP is a major cause of pain and disability worldwide and imposes huge costs on health systems, patients and society, with exercise being an important conservative treatment modality.

Objectives

The aim of this review was to assess the effectiveness of different exercise treatments for LDH.

Methods

Databases (MEDLINE, Pubmed, Cochrane, Scopus, Web of Science(WoS), ScienceDirect) were systematically searched for full-text articles published from 2018 to 23. Two researchers were involved in the research process. Studies evaluating pain, functional disability, quality of life, and transversus abdominis activation capacity in patients with LDH were included. Only studies published in English were considered. Randomized controlled trials (RCTs) with full-text availability, involving patients diagnosed with LDH who had not undergone surgery and were able to exercise, were included. The PEDro scale was used to assess the quality of evidence. According to the guidelines, the PEDro evaluation was carried out by the authors.

Results

Twelve randomized controlled trials (RCTs) were included (PubMed: 8, ScienceDirect: 3, WoS: 1), involving 880 participants and comparing exercise with other approaches. The articles examined core stabilization exercises (CSE), motor control exercises (MCE), clinical Pilates, yoga, and various other types of exercise. Pain, functional disability, quality of life (QoL), and transversus abdominis (TrA) activation capacity were evaluated in patients with LDH. Increased pain, greater disability, decreased QoL, and reduced TrA activation capacity were reported in LDH. The latest search was conducted on November 20, 2023. This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Conclusions

Quick Response (QR) code home-based exercise intervention and neurodynamic mobilisation and motor control exercises, scored higher than the other trials in terms of methodological quality and quality of evidence.