• Gunilla Limbäck Svensson, Gunilla Kjellby Wendt, and Roland Thomeé.
• Department of Physiotherapy, Sahlgrenska University Hospital/Mölndal, SE-431 80 Mölndal, Sweden. gunilla.limback_svensson@vgregion.se.
• J Rehabil Med. 2014 Mar 1;46(3):233-40.

ObjectiveTo evaluate a structured physiotherapy treatment model in patients who qualify for lumbar disc surgery.DesignA prospective cohort study.PatientsForty-one patients with lumbar disc herniation, diagnosed by clinical assessments and magnetic resonance imaging.MethodsPatients followed a structured physiotherapy treatment model, including Mechanical Diagnosis and Therapy (MDT), together with graded trunk stabilization training. Study outcome measures were the Oswestry Disability Index, a visual analogue scale for leg and back pain, the Tampa Scale for Kinesiophobia, the European Quality of Life in 5 Dimensions Questionnaires, the Zung Self-Rating Depression Scale, the Self-Efficacy Scale, work status, and patient satisfaction with treatment. Questionnaires were distributed before treatment and at 3-, 12- and 24-month follow-ups.ResultsThe patients had already improved significantly (p < 0.001) 3 months after the structured physiotherapy treatment model in all assessments: disability, leg and back pain, kinesiophobia, health-related quality of life, depression and self-efficacy. The improvement could still be seen at the 2-year follow-up.ConclusionThis study recommends adopting the structured physiotherapy treatment model before considering surgery for patients with symptoms such as pain and disability due to lumbar disc herniation.

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