In both the randomized (two group) and as-treated
(three group) analyses, the patients treated with
exercise and education achieved greater improvements
in the SF-36 role physical and bodily pain
scales and the physical component summary.
Additionally, in the as-treated analysis, the exercise
and education group achieved greater improvements
in SF-36 physical function scale. No
differences were identified between the exercise
and education group and the education-only group
in the as-treated analyses. This is best explained by
the loss of statistical power resulting from the high
number of participants who did not adhere to their
assignment in the education only group. The results
of the current study are similar to those of Harts
and colleagues.12 In that study, greater increases in
SF-36 scores were achieved in a group participating
in a high-intensity lumbar extensor program, as
compared with both low-intensity and a control
group. However, the participants in that study had
chronic LBP without signs of nerve root compression
and had not received a lumbar spine surgical
intervention. Although several studies27–31 have
examined the effects of rehabilitation following
lumbar diskectomy, only one reported the effects of
rehabilitation on health-related quality of life.28 In
that study, an eight-week exercise program, targeting
trunk muscle performance and hip mobility
combined with a behavioral approach including
graded activity, was compared with one session of
home exercise instruction following beginning 0–3
weeks following first-time lumbar microdiskectomy.
Health-related quality of life was measured
using both the SF-36 and the European Quality of
Life Scale (EuroQol). In contrast to the current
study, the group receiving the home-based program
achieved greater increases in three of the SF-36
scales and the EuroQol visual analogue scale. To
our knowledge, the current study is the first to
demonstrate greater improvements in healthrelated
quality of life from a standardized clinicbased
exercise program in patients post lumbar
microdiskectomy.