1
|
Kaya DO, Celenay ST, Secer E, Biceroglu H. Pain intensity, spine structure, and body composition in patients with acute discogenic lumbar radiculopathy. Musculoskelet Sci Pract 2024; 73:103133. [PMID: 38968681 DOI: 10.1016/j.msksp.2024.103133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 06/16/2024] [Accepted: 07/01/2024] [Indexed: 07/07/2024]
Abstract
OBJECTIVE This study aimed to compare the pain intensity, spine structure, and body composition according to functional disability levels in patients with acute discogenic lumbar radiculopathy (DLR). METHODS A total of 118 women (n = 83) and men (n = 35) patients with acute DLR (mean age: 51.87 ± 13.38 years) were included in the study. The function ability was measured with the Oswestry Disability Index, pain intensity was measured with the Visual Analogue Scale, spine structure was measured with the Spinal Mouse® device, and body composition was measured with the Bioelectrical Impedance Analysis System. RESULTS Patients with mild functional disability levels had significantly lower activity (p˂.001) and night pain intensity (p = 0.001) than patients with moderate, severe, and completely functional disability levels, and patients with completely functional disability levels had significantly higher rest pain intensity (p = 0.005) than patients with mild, moderate, and severe functional disability levels. Patients with mild functional disability levels had significantly better spine check scores (p = 0.001), posture (p = 0.005), and mobility (p = 0.003) than patients with moderate, severe, and completely functional disability levels. Patients with mild functional disability levels had significantly lower fat percentage (p = 0.032), and higher basal metabolic rate (p = 0.024) than patients with moderate, severe, and completely functional disability levels. CONCLUSION Pain intensity, spinal structure, and body composition of acute DLR patients differ greatly according to their functional disability levels. Although it is known that the level of functional disability of patients is a result of the severity or prognosis of the disease, performing different treatment methods aimed at decreasing the functional disability level of patients by health professionals may be important in terms of coping with the disease.
Collapse
Affiliation(s)
- Derya Ozer Kaya
- Izmir Katip Celebi University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Izmir, Turkey; Izmir Katip Celebi University, Physiotherapy and Rehabilitation Research and Application Center, Izmir, Turkey.
| | - Seyda Toprak Celenay
- Ankara Yıldırım Beyazıt University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Ankara, Turkey.
| | - Erhan Secer
- Manisa Celal Bayar University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Manisa, Turkey.
| | - Huseyin Biceroglu
- Ege University, Faculty of Medicine, Department of Brain and Nerve Surgery, Izmir, Turkey.
| |
Collapse
|
2
|
Gupta A. Evolving Spinal Treatment Modalities: A Review of the Literature on Non-surgical Interferential Differential Dynamics (IDD) Therapy. Cureus 2024; 16:e59873. [PMID: 38854340 PMCID: PMC11157978 DOI: 10.7759/cureus.59873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2024] [Indexed: 06/11/2024] Open
Abstract
Low back pain is one of the most common ailments encountered by physicians and orthopedic surgeons. There are various modalities used to treat low back pain, including conservative management, and a few of them involve rest, medications, massage, bracing, acupuncture, and physical therapy. Though most of the patients improve with conservative management, the burden of this disease has been very high and caused a significant amount of economic loss. Therefore, in-depth knowledge of all conservative methods is essential for physicians managing low back pain. Furthermore, there can be many causes of low back pain. Some of the more common ones are mechanical back pain due to paraspinal muscles or facetal in origin, discogenic back pain, and sacroiliac joint dysfunction. Many patients, especially the older population, have the discogenic origin as the more common cause of back pain, and traction therapy has been used for its treatment for ages. In this review, we discuss non-surgical spinal decompression/traction therapy popularly known as interferential differential dynamics (IDD) therapy with its current standing and recent advancement.
Collapse
Affiliation(s)
- Anuj Gupta
- Orthopedics: Spine, Triveni Ortho and Spine Center, Delhi, IND
- Spine, Max Superspeciality Hospital, Delhi, IND
| |
Collapse
|
3
|
Shah S, Khemani S, Mhase S, Khan SN, Pashine AA, Patil MS. Impact of Dorn Therapy on a Patient With a Prolapsed Intervertebral Disc: A Case Report. Cureus 2022; 14:e29023. [PMID: 36249665 PMCID: PMC9550201 DOI: 10.7759/cureus.29023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 09/11/2022] [Indexed: 11/05/2022] Open
Abstract
A prolapsed intervertebral disc (PIVD) refers to herniation of the nucleus pulposus out of the intervertebral space. Mechanical nerve compression brought on by a protruding nucleus pulposus and an increase in chemokines in the affected area causes the underlying pain, which is typically treated conventionally with surgery or medication. Nonetheless, these management strategies may not always be effective and may impact a person’s quality of life. This report highlights the case of a 31-year-old male patient, who complained of neck and low back pain associated with tingling sensations for two months, and was treated with Dorn Therapy (DT) which is the basis of pain management intervention in conjunction with spinal traction, spinal mobilization, stretching, muscular strength training, and transcutaneous electrical nerve stimulation. Following a week of pain management techniques, DT significantly reduced pain, improved range of motion, and enhanced muscle strength. This case report highlights the impact of DT on pain associated with a PIVD, which may curtail an individual’s well-being.
Collapse
|
4
|
Amjad F, Mohseni-Bandpei MA, Gilani SA, Ahmad A, Hanif A. Effects of non-surgical decompression therapy in addition to routine physical therapy on pain, range of motion, endurance, functional disability and quality of life versus routine physical therapy alone in patients with lumbar radiculopathy; a randomized controlled trial. BMC Musculoskelet Disord 2022; 23:255. [PMID: 35296293 PMCID: PMC8924735 DOI: 10.1186/s12891-022-05196-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 03/08/2022] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Lumbar radiculopathy is an extensively common complaint reported by patients of low back pain (LBP), resulting in several impairments. A comparatively novel technique, non-surgical spinal decompression (NSD), is introduced, which uses a sensitive computerized feedback mechanism and decompresses the spinal nerve roots through segmental distraction. The objective of this study was to determine the effects of NSD therapy in addition to routine physical therapy on pain, lumbar range of motion (ROM), functional disability, back muscle endurance (BME), and quality of life (QOL) in patients with lumbar radiculopathy. METHODS A total of sixty patients with lumbar radiculopathy were randomly allocated into two groups, an experimental (n = 30) and a control (n = 30) group, through a computer-generated random number table. Baseline values were recorded before providing any treatment by using a visual analogue scale (VAS), Urdu version of Oswestry disability index (ODI-U), modified-modified Schober's test (MMST), prone isometric chest raise test, and Short Form 36-Item Survey (SF-36) for measuring the pain at rest, functional disability, lumbar ROM, BME, and QOL, respectively. All patients received twelve treatment sessions over 4 weeks, and then all outcome measures were again recorded. RESULTS By using the ANCOVA test, a statistically significant (p < 0.05) between-group improvement was observed in VAS, ODI-U, BME, lumbar ROM, role physical (RP), and bodily pain (BP) domains of SF-36, which was in favour of NSD therapy group. The between-group difference was 1.07 ± 0.32 cm (p < .001) for VAS, 5.65 ± 1.48 points (p < .001) for ODI-U, 13.93 ± 5.85 s (p = 0.002) for BME, 2.62 ± 0.27 cm (p < .001) for lumbar flexion, 0.96 ± 0.28 (p < .001) for lumbar extension, 5.77 ± 2.39 (p = 0.019) for RP and 6.33 ± 2.52 (p = 0.016) for BP domain of SF-36. For these outcomes, a medium to large effect size (d = 0.61-2.47, 95% CI: 0.09-3.14) was observed. CONCLUSION It was concluded that a combination of non-surgical spinal decompression therapy with routine physical therapy is more effective, statistically and clinically, than routine physical therapy alone in terms of improving pain, lumbar range of motion, back muscle endurance, functional disability, and physical role domain of quality of life, in patients with lumbar radiculopathy, following 4 weeks of treatment. TRIAL REGISTRATION WHO Iranian registry of clinical trials ( IRCT20190717044238N1 ) Dated: 23.12.2019.
Collapse
Affiliation(s)
- Fareeha Amjad
- University Institute of Physical Therapy, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
| | - Mohammad A. Mohseni-Bandpei
- University Institute of Physical Therapy, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
- Pediatric Neurorehabilitation Research Center, the University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Ashfaq Ahmad
- Department University Institute of Physical Therapy, Faculty of Allied Health Sciences, Lahore, Pakistan
| | - Asif Hanif
- University Institute of Physical Therapy, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan
| |
Collapse
|
5
|
Choi E, Gil HY, Ju J, Han WK, Nahm FS, Lee PB. Effect of Nonsurgical Spinal Decompression on Intensity of Pain and Herniated Disc Volume in Subacute Lumbar Herniated Disc. Int J Clin Pract 2022; 2022:6343837. [PMID: 36263240 PMCID: PMC9553669 DOI: 10.1155/2022/6343837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 06/27/2022] [Accepted: 08/11/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Nonsurgical spinal decompression therapy (NSDT) is a conservative treatment for the lumbosacral herniated intervertebral disc (L-HIVD). This study aimed to evaluate the clinical effectiveness of the NSDT and change in disc volume through magnetic resonance imaging (MRI) in subacute L-HIVD. METHODS Sixty patients with subacute L-HIVD were randomized into either the decompression group (group D, n = 30) or the nondecompression group (group N, n = 30). In group D, NSDT was performed ten times in eight weeks. In group N, pseudodecompression therapy (no force) was performed with the same protocol. Lower back and lower leg pain intensities and functional improvements were measured by the visual analog scale and the Korean Oswestry Disability Index (K-ODI). The change in the lumbosacral disc herniation index (HI) was evaluated through a follow-up MRI three months after the therapy. RESULTS The lower leg pain intensity in group D was lower than that in group N at two months (p=0.028). Additionally, there were significantly lower K-ODI scores in group D at two and three months (p=0.023, 0.019) than in group N. The change in HI after the therapy was -27.6 ± 27.5 (%) in group D and -7.1 ± 24.9 (%) in group N, with a significant difference (p=0.017). Approximately 26.9% of patients in group D and no patients in group N showed over 50% reduction in HI (p=0.031). CONCLUSION NSDT may be a suitable treatment option for conservative treatment of subacute L-HIVD.
Collapse
Affiliation(s)
- Eunjoo Choi
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam 13620, Republic of Korea
| | - Ho Young Gil
- Department of Anesthesiology and Pain Medicine, Ajou University, School of Medicine, 164 World Cup-Ro, Yeongtong-Gu, Suwon 16499, Republic of Korea
| | - Jiyoun Ju
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam 13620, Republic of Korea
| | - Woong Ki Han
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam 13620, Republic of Korea
| | - Francis Sahngun Nahm
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam 13620, Republic of Korea
- Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul 03080, Republic of Korea
| | - Pyung-Bok Lee
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam 13620, Republic of Korea
- Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul 03080, Republic of Korea
| |
Collapse
|
6
|
Liu ZZ, Wen HQ, Zhu YQ, Zhao BL, Kong QC, Chen JY, Guo RM. Short-Term Effect of Lumbar Traction on Intervertebral Discs in Patients with Low Back Pain: Correlation between the T2 Value and ODI/VAS Score. Cartilage 2021; 13:414S-423S. [PMID: 33622056 PMCID: PMC8808794 DOI: 10.1177/1947603521996793] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The effect of lumbar traction on low back pain (LBP) patients is controversial. Our study aims to assess changes in the intervertebral disc water content after lumbar traction using T2 mapping and explore the correlation between changes in the T2 value and Oswestry Disability Index (ODI)/visual analogue scale (VAS) score. DESIGN Lumbar spine magnetic resonance imaging was performed, and the ODI/VAS scores were recorded in all 48 patients. Midsagittal T2-weighted imaging and T2 mapping were performed to determine the Pfirrmann grade and T2 value. Then, the T2 values were compared between pre- and posttraction, and the correlation between changes in the T2 value and ODI/VAS scores were examined. RESULTS In the traction group, the changes in the nucleus pulposus (NP) T2 values for Pfirrmann grades II-IV and the annulus fibrosus (AF) T2 values for Pfirrmann grade II were statistically significant after traction (P < 0.05). Changes in the mean NP T2 value of 5 discs in each patient and in the ODI/VAS score showed a strong correlation (r = 0.822, r = 0.793). CONCLUSION T2 mapping can be used to evaluate changes in the intervertebral disc water content. Ten sessions of traction resulted in a significant increase in quantitative T2 measurements of the NP in discs for Pfirrmann grade II-IV degeneration and remission of the patients' clinical symptoms in the following 6 months. Changes in the mean NP T2 value of 5 discs in each patient were strongly correlated with changes in the ODI/VAS score.
Collapse
Affiliation(s)
- Zhen-zhen Liu
- Department of Radiology, The Third
Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China,Jian-yu Chen, Department of Radiology, Sun
Yat-Sen memorial Hospital, Sun Yat-Sen University, 107 Yanjiang Road West,
Guangzhou, 510120, China.
| | - Hui-quan Wen
- Department of Radiology, The Third
Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Ye-qing Zhu
- Department of Radiology, Icahn School of
Medicine at Mount Sinai, New York, NY, USA
| | - Bin-liang Zhao
- Department of Radiology, The Third
Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Qing-cong Kong
- Department of Radiology, The Third
Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Jian-yu Chen
- Department of Radiology, Sun Yat-Sen
Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Ruo-mi Guo
- Department of Radiology, The Third
Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| |
Collapse
|
7
|
Effects of One-Fifth, One-Third, and One-Half of the Bodyweight Lumbar Traction on the Straight Leg Raise Test and Pain in Prolapsed Intervertebral Disc Patients: A Randomized Controlled Trial. BIOMED RESEARCH INTERNATIONAL 2021; 2021:2561502. [PMID: 34568490 PMCID: PMC8463178 DOI: 10.1155/2021/2561502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/09/2021] [Accepted: 08/25/2021] [Indexed: 12/17/2022]
Abstract
The prolapsed intervertebral disc (PIVD) at the lumbar spine is one of the most common causes of low back pain (LBP) affecting humans worldwide. Lumbar traction is widely used as a part of physiotherapeutic modalities for its treatment; however, reports on its effectiveness and dosage are conflicting. This study is aimed at comparing the acute effects of three traction forces on the straight leg raise (SLR) test and LBP intensity. A total of 45 (age 35.53 yrs., ±3.09) participants with 15 participants in each group were recruited for the study. Participants were divided into groups A, B, and C wherein traction forces equal to one-fifth, one-third, and one-half of their bodyweight were applied, respectively. SLR range of motion (ROM) and pain were examined before and immediately after the application of traction. Significant improvement was observed in SLR ROM in all three groups (p < 0.05). However, for pain, significant improvement (p < 0.05) was observed only in the group with one-half of bodyweight force. There was no significant difference (p > 0.05) between the three groups for both variables. All three forces were equally effective in immediately improving SLR ROM in patients suffering from lumbar PIVD; however, pain improvement was observed with one-half of bodyweight only.
Collapse
|
8
|
Vanti C, Turone L, Panizzolo A, Guccione AA, Bertozzi L, Pillastrini P. Vertical traction for lumbar radiculopathy: a systematic review. Arch Physiother 2021; 11:7. [PMID: 33715638 PMCID: PMC7958699 DOI: 10.1186/s40945-021-00102-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 02/08/2021] [Indexed: 12/24/2022] Open
Abstract
Background Only low-quality evidence is currently available to support the effectiveness of different traction modalities in the treatment of lumbar radiculopathy (LR). Yet, traction is still very commonly used in clinical practice. Some authors have suggested that the subgroup of patients presenting signs and symptoms of nerve root compression and unresponsive to movements centralizing symptoms may benefit from lumbar traction. The aim of this study is to conduct a systematic review of randomized controlled trials (RCTs) on the effects of vertical traction (VT) on pain and activity limitation in patients affected by LR. Methods We searched the Cochrane Controlled Trials Register, PubMed, CINAHL, Scopus, ISI Web of Science and PEDro from their inception to March 31, 2019 to retrieve RCTs on adults with LR using VT to reduce pain and activity limitation. We considered only trials reporting complete data on outcomes. Two reviewers selected the studies, extracted the results, and performed the quality assessment using the Risk of Bias and GRADE tools. Results Three studies met the inclusion criteria. Meta-analysis was not possible due to the heterogeneity of the included studies. We found very low quality evidence for a large effect of VT added to bed rest when compared to bed rest alone (g = − 1.01; 95% CI = -2.00 to − 0.02). Similarly, VT added to medication may have a large effect on pain relief when compared to medication alone (g = − 1.13; 95% CI = -1.72 to − 0.54, low quality evidence). Effects of VT added to physical therapy on pain relief were very small when compared to physical therapy without VT (g = − 0.14; 95% CI = -1.03 to 0.76, low quality evidence). All reported effects concerned short-term effect up to 3 months post-intervention. Conclusions With respect to short-term effects, VT may have a positive effect on pain relief if added to medication or bed rest. Long-term effects of VT are currently unknown. Future higher quality research is very likely to have an important impact on our confidence in the estimate of effect and may change these conclusions. Supplementary Information The online version contains supplementary material available at 10.1186/s40945-021-00102-5.
Collapse
Affiliation(s)
- Carla Vanti
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, 40138, Bologna, Italy
| | - Luca Turone
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, 40138, Bologna, Italy.
| | - Alice Panizzolo
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, 40138, Bologna, Italy
| | - Andrew A Guccione
- Department of Rehabilitation Science, College of Health and Human Services, George Mason University, Fairfax, VA, 22030, USA
| | - Lucia Bertozzi
- School of Physical Therapy, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Paolo Pillastrini
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, 40138, Bologna, Italy
| |
Collapse
|
9
|
Vanti C, Panizzolo A, Turone L, Guccione AA, Violante FS, Pillastrini P, Bertozzi L. Effectiveness of Mechanical Traction for Lumbar Radiculopathy: A Systematic Review and Meta-Analysis. Phys Ther 2021; 101:6056330. [PMID: 33382419 DOI: 10.1093/ptj/pzaa231] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 08/20/2020] [Accepted: 11/18/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Lumbar radiculopathy (LR) is a pain syndrome caused by compression/irritation of the lumbar nerve root(s). Traction is a well-known and commonly used conservative treatment for LR, although its effectiveness is disputed. The purpose of this systematic review and meta-analysis of randomized controlled trials was to evaluate the effects of different types of traction added to or compared with conservative treatments on pain and disability. METHODS Data were obtained from CENTRAL, PUBMED, CINAHL, Scopus, ISI Web of Science, and PEDro from their inception to April 2020. All randomized controlled trials on adults with LR, using mechanical traction, and without any restriction regarding publication time or language were considered. Two reviewers selected the studies, evaluated the quality assessment, and extracted the results. Meta-analysis used a random-effects model. Eight studies met the inclusion criteria, and 5 were meta-analyzed. RESULTS Meta-analyses of results from low-quality studies indicated that supine mechanical traction added to physical therapist treatments had significant effects on pain (g = -0.58 [95% confidence interval = -0.87 to -0.29]) and disability (g = -0.78 [95% confidence interval = -1.45 to -0.11]). Analyses of results from high-quality studies of prone mechanical traction added to physical therapist intervention for pain and disability were not significant. These results were also evident at short-term follow-up (up to 3 months after intervention). CONCLUSION The literature suggests that, for pain and disability in LR, there is short-term effectiveness of supine mechanical traction when added to physical therapist intervention. IMPACT This systematic review may be relevant for clinical practice due to its external validity because the treatments and the outcome measures are very similar to those commonly used in a clinical context.
Collapse
Affiliation(s)
- Carla Vanti
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Alice Panizzolo
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Luca Turone
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Andrew A Guccione
- Department of Rehabilitation Science, College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
| | - Francesco Saverio Violante
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Paolo Pillastrini
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Lucia Bertozzi
- School of Physical Therapy, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| |
Collapse
|
10
|
Singh V, Malik M, Kaur J, Kulandaivelan S, Punia S. A systematic review and meta-analysis on the efficacy of physiotherapy intervention in management of lumbar prolapsed intervertebral disc. Int J Health Sci (Qassim) 2021; 15:49-57. [PMID: 33708044 PMCID: PMC7934127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE The objective of this meta-analysis and systematic review is to analyze the efficacy of physiotherapy interventions in management of lumbar prolapsed intervertebral disc (PIVD). METHOD Randomized controlled trials (RCTs) were searched in PubMed and Cochrane Library using related keywords and advanced option, from commencement to January 2019. Quality of researches was assessed by PEDro scoring. Risk of bias and homogeneity were assessed using Cochrane risk of bias tool and I2value, respectively. Meta-analysis of included study was done using "Review manager (Software, version 5.3)." RESULTS Eleven RCTs were included in this systematic review. Six RCTs were excluded from meta-analysis due to insufficient data availability. Meta-analysis reveals significant decrease in pain (P = 0.001, mean difference (MD) -0.91; 95% confidence interval (CI) -0.35 to -1.48) and disability (P < 0.0001; MD -5.76; 95%CI; -3.18 to -8.34) with moderate heterogeneity (I2=40%; P = 0.17, I2=54%; P = 0.09, respectively). There was non-significant improvement in straight leg raise (SLR), P = 0.07; MD 7.96; 95%CI; -0.59-16.51 with moderate heterogeneity (I2=56%; P = 0.11). CONCLUSION Physiotherapy interventions are effective in management of lumbar PIVD. Physiological and biomechanical factors such as correction of the displaced disc, opening of the foramina, increase in intervertebral space, and reduction in herniation size with negative intradiscal pressure may be possible mechanisms.
Collapse
Affiliation(s)
- Varun Singh
- Department of Physiotherapy, Guru Jambheshwar University of Science and Technology, Hisar, India
| | - Manoj Malik
- Department of Physiotherapy, Guru Jambheshwar University of Science and Technology, Hisar, India
| | - Jaspreet Kaur
- Department of Physiotherapy, Guru Jambheshwar University of Science and Technology, Hisar, India,Address for correspondence: Dr. Jaspreet Kaur, Department of Physiotherapy, Guru Jambheshwar University of Science and Technology, Hisar, India. Phone: +91-9466092657. E-mail:
| | | | - Sonu Punia
- Department of Physiotherapy, Guru Jambheshwar University of Science and Technology, Hisar, India
| |
Collapse
|
11
|
Gaowgzeh RAM, Chevidikunnan MF, BinMulayh EA, Khan F. Effect of spinal decompression therapy and core stabilization exercises in management of lumbar disc prolapse: A single blind randomized controlled trial. J Back Musculoskelet Rehabil 2020; 33:225-231. [PMID: 31282394 DOI: 10.3233/bmr-171099] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Spinal decompression therapy (SDT) has recently been used as a conservative treatment for lumbar disc prolapse (LDP). The effectiveness of SDT when compared with other conservative techniques with a well-designed randomized controlled trials is lacking. OBJECTIVE To find the efficacy of SDT and core stabilization exercises (CSE) on pain and functional disability in individuals with chronic LDP, and to compare with CSE alone. METHODS This single blind randomized controlled trial included thirty-one participants with a mean age of 38.68 ± 8.79 having chronic LDP with or without radiating symptoms were included in the study. The study group received SDT with CSE and control group received CSE alone along with interferential therapy for both groups. Pain and disability were estimated by Numerical Rating Scale (NRS) and Modified Oswestry Questionnaire (mOQ). RESULTS The results demonstrated significant within-group improvements in all outcomes in both groups, the mean differences between pre to post intervention in SDT with CSE group were (NRS: 4.75, t= 12.81, p⩽ 0.001) and (mOQ: 45.13, t= 29.34, p⩽ 0.001), while in CSE group (NRS: 2.60, t= 13.67, p⩽ 0.001) and (mOQ: 27.67, t= 24.52, p⩽ 0.001). CONCLUSIONS A combination of SDT with CSE has proven to be more significant when compared with CSE alone to reduce pain and disability in subjects with chronic LDP.
Collapse
|
12
|
Lo WLA, Lei D, Leng Y, Huang H, Wang B, Yu Q, Li L. Impact of nonsurgical spinal decompression on paraspinal muscle morphology and mechanical properties in young adults with low back pain. J Int Med Res 2020; 48:300060520919232. [PMID: 32723102 PMCID: PMC7391436 DOI: 10.1177/0300060520919232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Objective The mechanism underlying the benefit of nonsurgical spinal decompression (NSSD) on low back pain is unclear. This study was performed to investigate the immediate impact of NSSD on the mechanical properties and morphology of the paraspinal muscles. Methods Participants with low back pain were recruited. NSSD therapy was provided on one occasion. A myotonometer was placed perpendicularly on the skin surface over the paraspinal muscle at the level of L3/L4 to measure the mechanical muscle properties. The multifidus thickness was measured using B-mode ultrasound and defined as the distance between the transverse process and subcutaneous tissue fascia. The difference between before and after NSSD was analyzed by a paired t-test. Results Thirty participants (mean age, 20.9 ± 0.8 years; 9 male, 21 female) were recruited. No significant difference was observed in the muscle mechanical properties or morphology between before and after the intervention. Conclusions NSSD intervention did not induce immediate changes in the paraspinal muscle mechanical properties or multifidus thickness in young adults with low back pain. NSSD might produce benefits by stimulating mechanical receptors rather than inducing morphological changes or mechanical property alterations of the muscle fibers. These parameters may not be suitable outcome measures for NSSD intervention.
Collapse
Affiliation(s)
- Wai Leung Ambrose Lo
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Engineering and Technology Research Center for Rehabilitation Medicine and Translation, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Di Lei
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yan Leng
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Engineering and Technology Research Center for Rehabilitation Medicine and Translation, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Huanjie Huang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Biru Wang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qiuhua Yu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Le Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Engineering and Technology Research Center for Rehabilitation Medicine and Translation, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
13
|
Lee CH, Heo SJ, Park SH, Jeong HS, Kim SY. The Functional and Morphological Changes of the Cervical Intervertebral Disc after Applying Lordotic Curve Controlled Traction: A Double-Blind Randomized Controlled Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16122162. [PMID: 31248064 PMCID: PMC6617374 DOI: 10.3390/ijerph16122162] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 06/14/2019] [Accepted: 06/16/2019] [Indexed: 12/19/2022]
Abstract
The newly developed cervical lordotic curve-controlled traction (C-LCCT) appears to be an ideal method to improve the treatment outcome in patients with cervical intervertebral disc disease. The purpose of this study was to investigate the treatment outcomes of C-LCCT including the functional and morphological changes of the cervical intervertebral disc compared to traditional traction (TT) with a randomized controlled trial design. A total of 40 patients with cervical intervertebral disc disease at the C5/6 level confirmed by magnetic resonance imaging were recruited and assigned to either the C-LCCT group or the TT group. The comprehensive health status changes of the patients were recorded using pain and functional scores (Visual Analogue Scale, Oswestry Disability Index) and morphological changes (cervical lordosis, cervical central canal area) before and after the traction treatment. Both groups showed a significant improvement in pain scores after traction (p < 0.05). The functional score and morphological changes improved significantly after treatment in the C-LCCT group. However, there was no significant improvement in the TT group (p < 0.05). The C-LCCT showed significant pain, functional, and morphological improvement compared to TT. C-LCCT could be effective in improving the treatment outcomes of the traction technique in patients with cervical intervertebral disc disease.
Collapse
Affiliation(s)
- Chang-Hyung Lee
- Rehabilitation Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Korea.
| | - Sung Jin Heo
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Korea.
| | - So Hyun Park
- Department of Physical Therapy, Youngsan University, Yangsan 50510, Korea.
| | - Hee Seok Jeong
- Radiology Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Korea.
| | - Soo-Yeon Kim
- Rehabilitation Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Korea.
| |
Collapse
|
14
|
Wei H, Tang H, Zhang T, Chen H, Dong C. Preliminary efficacy of inter-spinal distraction fusion which is a new technique for lumbar disc herniation. INTERNATIONAL ORTHOPAEDICS 2018; 43:899-907. [DOI: 10.1007/s00264-018-4188-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 09/24/2018] [Indexed: 12/26/2022]
|
15
|
Demirel A, Yorubulut M, Ergun N. Regression of lumbar disc herniation by physiotherapy. Does non-surgical spinal decompression therapy make a difference? Double-blind randomized controlled trial. J Back Musculoskelet Rehabil 2017; 30:1015-1022. [PMID: 28505956 DOI: 10.3233/bmr-169581] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND OBJECTIVES The aim of the study determining whether or not Non-invasive Spinal Decompression Therapy (NSDT) was effective in resorption of herniation, increasing disc height in patients with lumbar disc herniation (LHNP). METHODS A total of twenty patients diagnosed as LHNP and suffering from pain at least 8 weeks were enrolled to the study. Patients were allocated in study (SG) and control groups (CG) randomly. Both groups received combination of electrotherapy, deep friction massage and stabilization exercise for fifteen session. SG received additionally NSDT different from CG. Numeric Anolog Scale, Straight leg raise test, Oswestry Disability Index (ODI) were applied at baseline and after treatment. Disc height and herniation thickness were measured on Magnetic Resonance Imagination which performed at baseline and three months after therapy. RESULTS Both treatments had positive effect for improving pain, functional restoration and reduction in thickness of herniation. Although reduction of herniation size was higher in SG than CG, no significant differences were found between groups and any superiority to each other (p> 0.05). CONCLUSIONS This study showed that patients with LHNP received physiotherapy had improvement based on clinical and radiologic evidence. NSDT can be used as assistive agent for other physiotherapy methods in treatment of lumbar disc herniation.
Collapse
Affiliation(s)
- Aynur Demirel
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Samanpazarı, Ankara, Turkey
| | - Mehmet Yorubulut
- Radiology Department, Private Acıbadem Hospital, Cankaya, Ankara, Turkey
| | - Nevin Ergun
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Samanpazarı, Ankara, Turkey
| |
Collapse
|
16
|
Karimi N, Akbarov P, Rahnama L. Effects of segmental traction therapy on lumbar disc herniation in patients with acute low back pain measured by magnetic resonance imaging: A single arm clinical trial. J Back Musculoskelet Rehabil 2017; 30:247-253. [PMID: 27636836 DOI: 10.3233/bmr-160741] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Low Back Pain (LBP) is considered as one of the most frequent disorders, which about 80% of adults experience in their lives. Lumbar disc herniation (LDH) is a cause for acute LBP. Among conservative treatments, traction is frequently used by clinicians to manage LBP resulting from LDH. However, there is still a lack of consensus about its efficacy. OBJECTIVE The purpose of this study was to evaluate the effects of segmental traction therapy on lumbar discs herniation, pain, lumbar range of motion (ROM), and back extensor muscles endurance in patients with acute LBP induced by LDH. METHODS Fifteen patients with acute LBP diagnosed by LDH participated in the present study. Participants undertook 15 sessions of segmental traction therapy along with conventional physiotherapy, 5 times a week for 3 weeks. Lumbar herniated mass size was measured before and after the treatment protocol using magnetic resonance imaging. Furthermore, pain, lumbar ROM and back muscle endurance were evaluated before and after the procedure using clinical outcome measures. RESULTS Following the treatment protocol, herniated mass size and patients' pain were reduced significantly. In addition, lumbar flexion ROM showed a significant improvement. However, no significant change was observed for back extensor muscle endurance after the treatment procedure. CONCLUSION The result of the present study showed segmental traction therapy might play an important role in the treatment of acute LBP stimulated by LDH.
Collapse
Affiliation(s)
- Noureddin Karimi
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Parvin Akbarov
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.,Department of Physiotherapy, Tusi Memorial Clinic, Baku, Azerbaijan
| | - Leila Rahnama
- Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| |
Collapse
|
17
|
Giers MB, Munter BT, Eyster KJ, Ide GD, Newcomb AG, Lehrman JN, Belykh E, Byvaltsev VA, Kelly BP, Preul MC, Theodore N. Biomechanical and Endplate Effects on Nutrient Transport in the Intervertebral Disc. World Neurosurg 2017; 99:395-402. [DOI: 10.1016/j.wneu.2016.12.041] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 12/09/2016] [Accepted: 12/10/2016] [Indexed: 01/18/2023]
|
18
|
Seyithanoglu H, Aydin T, Taşpınar O, Camli A, Kiziltan H, Eris AH, Hocaoglu IT, Ozder A, Denizli E, Kepekci M, Keskin Y, Mutluer AS. Association between nutritional status and Modic classification in degenerative disc disease. J Phys Ther Sci 2016; 28:1250-4. [PMID: 27190462 PMCID: PMC4868222 DOI: 10.1589/jpts.28.1250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 01/08/2016] [Indexed: 01/07/2023] Open
Abstract
[Purpose] This study was conducted to examine the association between Modic classification and the eating habits in patients with degenerative disc disease (DDD) and to determine the influence of nutrition on disease severity. [Subjects and Methods] Sixty patients with DDD visiting a low back pain outpatient clinic were enrolled. Through face-to-face interviews, they completed questionnaires regarding their demographics, disease activity, smoking and alcohol use, concomitant diseases, disease duration, and nutritional status.Exclusion criteria were age <20 years or >65 years, other comorbidities, missing MRI data, and inability to speak Turkish. [Results] Forty patients were finally included in the study. The frequency with which they consumed water, salt, fast food, eggs, milk, yogurt, cheese, whole wheat bread, white bread, butter, and margarine was recorded. A weak negative correlation was observed between the Modic types and fish and egg consumption. [Conclusion] Modic changes, which indicate the severity of DDD, seem to be correlated to patients' dietary habits. However, studies with comparison groups and larger samples are needed to confirm our promising results before any cause-and-effect relationship can be proposed.
Collapse
Affiliation(s)
- Hakan Seyithanoglu
- Department of Neurosurgery, Faculty of Medicine, Bezmi Alem Vakıf University, Turkey
| | - Teoman Aydin
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Bezmi Alem Vakıf University, Turkey
| | - Ozgur Taşpınar
- Department of Physical Medicine and Rehabilitation, Cınarcik State Hospital, Turkey
| | - Adil Camli
- Department of Internal Medicine, Faculty of Medicine, Bezmi Alem Vakıf University, Turkey
| | - Huriye Kiziltan
- Department of Radiation Oncology, Faculty of Medicine, Bezmi Alem Vakıf University, Turkey
| | - Ali Hikmet Eris
- Department of Radiation Oncology, Faculty of Medicine, Bezmi Alem Vakıf University, Turkey
| | | | - Aclan Ozder
- Department of Family Medicine, Faculty of Medicine, Bezmi Alem Vakıf University, Turkey
| | - Ebru Denizli
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Bezmi Alem Vakıf University, Turkey
| | - Muge Kepekci
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Bezmi Alem Vakıf University, Turkey
| | - Yasar Keskin
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Bezmi Alem Vakıf University, Turkey
| | | |
Collapse
|
19
|
Ogata Y, Kamijo M, Hanaoka M. A quantitative assessment of the mechanical effects on the lumbar spine and the effects on straight leg raising and lumbar flexion of segmental sustained rotation. J Phys Ther Sci 2016; 28:1318-24. [PMID: 27190475 PMCID: PMC4868235 DOI: 10.1589/jpts.28.1318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 01/14/2016] [Indexed: 12/02/2022] Open
Abstract
[Purpose] This study were to examine the strength and relative direction of the applied
force from lumbar segmental sustained rotation (LSSR) on the lumbar spinous process, and
to clarify the effects of LSSR on straight leg raising (SLR) and lumbar flexion (LF).
[Subjects] 18 pain-free healthy adults volunteered for this study. [Methods] Applied force
and direction were measured between the L5–S1 segments using tri-axial pressure sensors.
Subjects participated in 3 trials. Subjects underwent localized right rotation, held for
10 seconds, of the L5 in relation to the S1. Sham group subjects followed LSSR group
protocols; however L5–S1 rotation was absent. Control subjects rested on a plinth. SLR and
LF were measured pre and post-trial. [Results] Outcome data for LSSR forces were as
follows; x (0.06N (±0.29)), y (‒5.26N (±0.01)), z (6.16N (±1.33)), and resultant vector
magnitude (8.19N (±1.12)). LSSR relative direction results were as follows: x-axis angle,
89. 6 ° (±1.5); y-axis, 130.9 ° (±5.6); and z-axis, 41.6 ° (±4.7). The LSSR group’s LF and
SLR were significantly increased compared with those of the sham and control groups.
[Conclusion] The identified resultant vector magnitude was 8.19N, less than other
techniques. LSSR effectively improves LF and bilateral SLR.
Collapse
Affiliation(s)
- Yoetsu Ogata
- Koriyama Institute of Health Sciences: 2-9-3 Zukei, Koriyama, Fukushima 963-8834, Japan
| | - Masayoshi Kamijo
- Course of Kansei Engineering, Faculty of Textile Science and Technology, Shinshu University, Japan
| | - Masaaki Hanaoka
- Koriyama Institute of Health Sciences: 2-9-3 Zukei, Koriyama, Fukushima 963-8834, Japan
| |
Collapse
|