AIM:The research aims to determine the influence of early goal-oriented physical therapy program in combination with educational booklet and standard physical therapy without written instructions on functional mobility outcomes in patients after low back surgery.MATERIAL AND METHODS:Thirty patients with similar functional impairments were randomly divided into two groups, a control group (CG n = 10) and an experimental group (EG n = 20). The outcome measures include time to move from lying to sitting position, the TUG test and the 6-meter walk test. Rehabilitation program includes daily physical therapy with mild to moderate intensity, achieving sitting position and education sessions how to perform activities of daily living (ADL) from the first day after surgery.RESULTS:There was a significant improvement from baseline in two groups for all performed tests (p < 0.001). Statistical significant differences between two groups for transfers in bed on discharge (p < 0.05), in one month (p < 0.01) and for TUG in one month (p < 0.05) were found.CONCLUSION:The study revealed that early rehabilitation program consists of therapeutic exercises and written educational booklet after low back surgery improves transfer abilities and basic activities in one month.

The purpose of this study is to evaluate the effect of one-month specialized physiоtherapy program on activities of daily live in patients with disc herniation after spinal surgery. Twenty patients with disc herniation after surgery were studied. They were divided into two groups, a control group (СG n=10) and an experimental group (EG n=10). The assessment was made on the day of discharge and one month after surgery. The Activities in Daily Living (ADL) were examined with Oswestry disability index and Functional gait assessment test. Gait training and exercises imitating the ADL at home for one month after surgery were given to the EG. The CG was received standard physical therapy program. The results show that the highest improvement in the ADL was seen in sitting, standing and social life. The biggest difference in walking was observed in walking in different directions and walking backward. Discussion: Postoperative management of patients undergoing spinal surgeries emphasize suitable positioning coupled with patient education and advice on reinforcing self-management and on building activities appropriately. Proper implementation of the ADL lead to faster recovery and increase the independence in daily living. Conclusions: The performance of ADL exercises combined with gait training may significantly improve the possibilities for walking and increace the independence in daily living in patients after lumbar disc herniation surgery.

Low back pain is a common disorder and is an important and serious health and social problem. The prevalence and economic burden grow exponentially. Over 350 000 people per year seek consultation with a neurologist and neurosurgeon because of lower back pain in Bulgaria. The pain is provoked most often by improper posture or lifting weights. It is strong and sometimes leads to significantly impaired performance and an inability to get out of bed. Walking and moving are difficult to impossible. Treatment can be conservative or operative. Neurosurgical techniques are continuously evolving in order to facilitate and optimize healing processes. Physiotherapy is essential for functional recovery of the patients after operation, related to overcome the complications, the fatigue and the delayed functional recovery. Various specialized methods as postisometric relaxation, proprioceptive neuromuscular facilitation, neurocognitive methodology of Perfetti, neurodevelopment treatment and therapeutic exercises for motor recovery are recommended in order to improve the independence and health related quality of life of the patients.

Purpose. The purpose of the study is to determine the influence of specialized physiotherapy program on gait in patients after lumbar spinal surgery. Methodology The contingent includes-80 patients, of which 38 males and 42 females. The assessment was made on the first day after surgery, on the day of discharge and one month after surgery. The gait was examined with a Functional gait assessment (FGA) test and 6 meters walking test. All patients underwent daily exercises including proprioceptive neuromuscular facilitation (PNF) during hospital stay and performed a home exercise program for one month after discharge. Results There were significant improvements in the first month in аll functional aspects of the gait. Discussion The specialized early physical therapy including PNF and home exercise program leads to improved gait and walking speed. Conclusions The study showed that the use of physiotherapy during hospital stay and one month after surgery positively influenced the functionality and speed of walking in patients after spinal surgery.