[Impact of different exercise modalities on electrophysiology and soft tissue function following lumbar discectomy].

OBJECTIVE: To investigate the mechanism underlying the effects of supine air straight leg pushing on muscle group regulation and musculoskeletal balance in patients following transforaminal endoscopic lumbar discectomy (TELD).

METHODS: Thirty-eight patients who underwent transforaminal endoscopic lumbar discectomy(TELD) between July 2024 and January 2025 were selected and divided into a exercise group and a Feiyan exercise group according to different postoperative exercise methods, with 19 patients in each group. Both groups received 4 weeks of postoperative rehabilitation exercises after suture removal at 2 weeks postoperatively. The exercise group included 19 patients:12 males and 7 females;9 patients on the left side and 10 patients on the right side;aged from 25 to 61 years old with an average of (40.37±10.40) years old;10 patients with surgical segments at L4,5 and 9 patients at L5S1;body mass index (BMI) ranging from 19.72 to 27.68 kg·m-2 with a mean of (23.48±2.46) kg·m-2;they received supine straight-leg kicks exercises. The Feiyan exercise group included 19 patients:16 males and 3 females;9 patients on the left side and 10 patients on the right side;aged from 25 to 67 years old with a mean of (40.16±10.86) years old;11 patients with surgical segments at L4,5 and 8 patients at L5S1;BMI ranging from 18.43 to 29.28 kg·m-2 with a mean of (24.49±2.88) kg·m-2;they received Feiyan exercises. The visual analogue scale (VAS) and Oswestry disability index (ODI) were compared between the two groups before exercise and 4 weeks after exercise. The maximal voluntary contraction (MVC), root mean square (RMS), integral of the EMG signal (INT), mean power frequency (MPF), and RMS as a percentage of maximal voluntary contraction (RMS/MVC value, %MVC) of the erector spinae, rectus abdominis, vastus medialis, vastus lateralis, and gastrocnemius on the affected side were compared between the two groups before and after exercise. Additionally, the muscle oscillation frequency (F value), dynamic stiffness (S value), and logarithmic decrement of a muscle's natural oscillation (D value) of the erector spinae, rectus abdominis, vastus medialis, vastus lateralis, and gastrocnemius on the affected side were compared between the two groups before and after exercise.

RESULTS: After exercise, the VAS score of the exercise group was lower than that before exercise;the ODI scores of both groups after exercise were lower than those before exercise, with statistically significant differences (P<0.05). There was no statistically significant difference in the VAS score of the Feiyan exercise group between after and before exercise (P>0.05). After exercise, the VAS and ODI scores of the exercise group were lower than those of the Feiyan exercise group, with statistically significant differences (P<0.05). After exercise, the RMS, INT, MPF, and %MVC values of the erector spinae in the exercise group were lower than those in the Feiyan exercise group, with statistically significant differences (P<0.05). After exercise, the MVC, RMS, INT, and %MVC values of the rectus abdominis in the exercise group were higher than those in the Feiyan exercise group, while the MPF value was lower, with statistically significant differences (P<0.05). After exercise, the F and S values of the erector spinae in the Feiyan exercise group were higher than those before exercise;the D values of the rectus abdominis, vastus medialis, and vastus lateralis in the exercise group after exercise were lower than those before exercise, with statistically significant differences (P<0.05).

CONCLUSION: Supine Straight-Leg Kicks can effectively alleviate postoperative pain, promote the recovery of lumbar function, activate core muscles, enhance the synergistic effect of lower limb muscle groups, and improve muscle tension, stiffness, and elasticity. It can provide a new option for rehabilitation exercise after lumbar endoscopic surgery.