自宅でのビデオガイド付き運動プログラムは、腰椎手術後の機能的および心理的回復を強化する：準ランダム化比較試験

ObjectiveTo evaluate the long-term effects of a structured, home-based, video-guided exercise programme on disability, health-related quality of life, fear of movement, and depressive symptoms after lumbar spine surgery.DesignQuasi-randomized controlled trial.SettingSingle university-affiliated spine centre in Japan.ParticipantsOne hundred ninety-six patients (mean age 70 years, 62% male) who underwent posterior decompression surgery for lumbar disc herniation or spinal canal stenosis. Of these, 168 patients (84 per group) completed the 24-month follow-up.InterventionParticipants were assigned by hospital registration number to a video-guided exercise group (n = 103) or a control group (n = 93). The intervention group performed a 15-min daily home exercise routine for 2 years. The control group received standard post-operative care.Main measuresPrimary outcomes were disability (Oswestry disability index), fear of movement (Tampa Scale for Kinesiophobia), and Physical Function and General Health (36-Item Short Form Survey). Secondary outcomes included depressive symptoms (Zung Self-Rating Depression Scale) and pain (10-cm Visual Analogue Scale). Assessments occurred pre-operatively and at 1, 3, 6, 12, and 24 months. Longitudinal analysis used mixed-effects models.ResultsThe intervention group had significantly lower disability and fear of movement scores throughout (p < 0.05). Physical Function and General Health were higher, and depressive symptoms were significantly lower at 1, 6, and 12 months. Pain did not differ at 12 or 24 months.ConclusionsA home-based video-guided exercise programme improved long-term physical and psychological outcomes after lumbar spine surgery. This low-cost, scalable method may enhance standard rehabilitation.