Letter to the Editor. Lumbar muscle strength changes after fusion: only due to rehabilitation exercises?

Effectiveness of a 12-month home-based exercise program on trunk muscle strength and spine function after lumbar spine fusion surgery: a randomized controlled trial

“…In our study, the early postoperative treatment was more activating: patients were encouraged to gradually increase their activity level, and no orthosis was used postoperatively. In the study by Lee et al, the patients were allowed to use full spine range of movement in training [38], while in the present study, special attention was paid to not overload the fused area; therefore, the homebased training program consisted of exercises that allowed the lumbar spine to be kept in a neutral position.…”

“…In the previous nonrandomized controlled trial by Lee et al (2017), in which the three-month supervised intervention was also started three months postoperatively [37], the exercise group showed even the 64% increase in extension strength, while the control group improved 22% after three months of training [37]. However, in that study, the patients used rigid lumbosacral orthosis for the first three postoperative months [38]. Therefore, an immobilization-induced strength deficit at the beginning of the exercise intervention may have resulted in larger strength improvements in both groups.…”