In 1994, Johannsen, et. al., aimed to assess the efficacy of intensive supervised training versus home training in patients following their first lumbar diskectomy.

In a randomized clinical trial, forty patients post-first lumbar diskectomy were assigned to either a supervised training group, participating in supervised sessions twice a week for three months at an outpatient clinic, or a home training group, provided with two hours of instruction for independent training at home.

Both rehabilitation models demonstrated significant positive effects on spinal mobility, isokinetic trunk flexion strength, isokinetic trunk extension strength, and daily function. These improvements remained consistent at the three-month follow-up. Pain scores, however, exhibited no significant change in either group throughout the trial. No statistically significant differences in the effects of the two rehabilitation models were observed across the assessed parameters. Thirteen patients did not complete the trial, with nine from the supervised endurance trained group discontinuing, primarily due to increased pain and reprolaps (n = 4). In the home trained group, four patients dropped out, with only one citing increased pain as the reason. Despite differences in dropout rates and training side effects, statistical significance was not achieved.

This study concludes that implementing three months of supervised intensive endurance training, as opposed to home training, may not be justified for all cases of first lumbar diskectomy. Although both rehabilitation models demonstrated positive effects, suggesting potential benefits and improved compliance for a select group of patients, the overall findings did not support the universal adoption of intensive supervised training. Further research may identify specific patient profiles that would benefit more from one rehabilitation model over the other.

Reference: Johannsen, F., Remvig, L., Kryger, P., Beck, P., Lybeck, K., Larsen, L. H., & Dreyer, V. (1994). Supervised endurance exercise training compared to home training after first lumbar diskectomy: a clinical trial. Clinical and experimental rheumatology, 12(6), 609-614.