Rehabilitation after lumbar spine surgery in adults: a systematic review with meta-analysis

Table 2 GRADE assessment: supervised exercise compared to non-supervised exercise

Supervised exercise compared to non-supervised exercise for patients after surgery for lumbar disk herniation Patient or population: patients after surgery for lumbar disk herniation Setting: Hospital Intervention: supervised exercise Comparison: non-supervised exercise
Outcomes	№ of participants studies) Follow-up	Certainty of the evidence (GRADE)	Relative effect (95% CI)	Anticipated absolute effects
Outcomes	№ of participants studies) Follow-up	Certainty of the evidence (GRADE)	Relative effect (95% CI)	Risk with nonsupervised exercise	Risk difference with supervised exercise
Pain assessed with: Visual Analogue Scale (cm) Scale from: 0 to 10 follow-up: mean 4 months	250 (5 RCTs)	⨁⨁◯◯ Low^a,b	-		MD 1.14 lower (1.65 lower to 0.62 lower)
Disability follow-up: mean 4 months	175 (4 RCTs)	⨁⨁◯◯ Low^b,c	-	-	SMD 0.7 SD Lower (1.14 lower to 0.26 lower)
Lumbar Mobility assessed with: Schober Test (cm) follow-up: mean 3 months	68 (2 RCTs)	⨁⨁◯◯ Low^b,d	-		MD 0.27 lower (0.7 lower to 0.16 higher)

CI confidence interval, MD mean difference, SMD standardised mean difference
GRADE Working Group grades of evidence
High certainty: we are very confident that the true effect lies close to that of the estimate of the effect.
Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.
Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect.
Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect.
^*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
Explanations
^a3 of 5 studies are at high risk of bias
^bN<400
^c2 of 4 studies at high risk of bias
^d2 of 3 studies at high risk of bias

ISSN: 2057-0082