This randomized controlled trial aims to compare the effectiveness of early mobilization alone versus early mobilization combined with electrical stimulation on functional recovery following lumbar disc herniation surgery. Lumbar disc herniation is a common cause of low back pain and functional limitation, significantly affecting quality of life.
Although surgical intervention is effective in patients who do not respond to conservative treatment, optimal postoperative recovery largely depends on appropriate rehabilitation strategies. Early mobilization is widely recommended to prevent complications, preserve muscle function, and facilitate return to daily activities. In addition, electrical stimulation modalities such as neuromuscular electrical stimulation (NMES) and transcutaneous electrical nerve stimulation (TENS) have been increasingly integrated into rehabilitation programs to enhance pain control, muscle activation, and neuromuscular re-education.
In this study, a total of 60 participants who have undergone primary lumbar disc herniation surgery will be randomly assigned into two groups. The first group will receive an early mobilization program alone, while the second group will receive early mobilization combined with electrical stimulation (NMES/TENS). The intervention period will last 6 to 8 weeks, with sessions conducted three times per week.
Primary outcomes include functional disability measured by the Oswestry Disability Index (ODI) and pain intensity measured by the Visual Analog Scale (VAS). Secondary outcomes include functional mobility assessed by the Timed Up and Go (TUG) test, walking speed assessed by the 10-Meter Walk Test (10MWT), and muscle strength evaluated using manual muscle testing (MMT).
The findings of this study are expected to contribute to the development of evidence-based postoperative rehabilitation protocols and to clarify the clinical effectiveness of electrical stimulation in patients undergoing lumbar disc herniation surgery
Age between 18 and 65 years
Patients who have undergone primary lumbar disc herniation surgery
Being in the early postoperative period (within the first 2 weeks after surgery)
Clinically stable condition
History of previous spinal surgery
Presence of severe neurological deficits (e.g., progressive motor loss, cauda equina syndrome)
Contraindications to electrical stimulation (e.g., pacemaker, implanted electronic devices)
Presence of severe systemic or uncontrolled chronic diseases (e.g., severe cardiovascular, respiratory, or metabolic disorders)
Parallel
Early Mobilization Program
Other interventionA structured early mobilization program initiated in the early postoperative period following lumbar disc herniation surgery. The program includes gradual ambulation, posture training, range of motion exercises, and functional activity training. Sessions will be conducted three times per week for 6-8 weeks. The program is designed to improve functional recovery, mobility, and independence in daily activities.
Electrical Stimulation (NMES/TENS)
DeviceElectrical stimulation will be applied as an adjunct to early mobilization in the postoperative rehabilitation of lumbar disc herniation. Neuromuscular electrical stimulation (NMES) will be used to facilitate muscle activation and prevent muscle atrophy, while transcutaneous electrical nerve stimulation (TENS) will be used for pain modulation. Stimulation will be applied to paraspinal and lower extremity muscle groups according to patient tolerance and clinical indications. Sessions will be conducted three times per week for 6-8 weeks.
Oswestry Disability Index (ODI)
The Oswestry Disability Index (ODI) will be used to evaluate functional disability related to low back pain following lumbar disc herniation surgery. The questionnaire consists of 10 sections assessing activities of daily living including pain intensity, personal care, lifting, walking, sitting, standing, sleeping, social life, and traveling. Each section is scored from 0 to 5, and total scores are expressed as a percentage, with higher scores indicating greater disability.
Visual Analog Scale (VAS) for Pain
Pain intensity will be assessed using the Visual Analog Scale (VAS), a 10 cm horizontal line ranging from 0 (no pain) to 10 (worst imaginable pain). Participants will mark their perceived pain level. The VAS is widely used for both acute and chronic pain assessment and is highly sensitive to clinical change.
Timed Up and Go Test (TUG)
The Timed Up and Go (TUG) test will be used to assess functional mobility and balance. Participants will rise from a standard chair, walk 3 meters, turn, return, and sit down. The time in seconds will be recorded, with lower times indicating better functional mobility.
10-Meter Walk Test (10MWT)
Walking speed will be evaluated using the 10-Meter Walk Test. Participants will walk a 10-meter distance at a comfortable pace, and time will be recorded. Walking speed (m/s) will be calculated, with higher values indicating better functional ambulation capacity.
Manual Muscle Testing (MMT)
Muscle strength will be assessed using Manual Muscle Testing (MMT), graded on a 0-5 scale. A score of 0 indicates no muscle contraction, while 5 indicates normal muscle strength. Key muscle groups of the lower extremity and paraspinal region will be evaluated.
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