Effects of adding neural mobilization to traditional physical therapy on pain, functional disability, and H-reflex in patients after lumbar laminectomy: A randomized controlled trial

2021 ◽  
pp. 026921552110341
Author(s):  
Moussa A Sharaf ◽  
Soheir S Rezkallah ◽  
Khalid Z Fouda ◽  
Nevein MM Gharib

Objective: To investigate whether adding neural mobilization to a standard postoperative physical therapy program could improve the outcomes of patients after lumbar laminectomy. Design: A single blinded randomized controlled trial. Setting: Outpatient setting. Participants: Sixty participants of both sexes who had undergone lumbar laminectomy. Interventions: Participants were allocated randomly to two groups; study and control groups. All patients received a standard postoperative physical therapy program. Those in the study group received additional neural mobilization in the form of straight leg raising and dorsiflexion with two-ended slider. Treatment was administered three times/week for six successive weeks. Outcome measures: Visual analog scale (VAS), Oswestry disability index (ODI), and H-reflex latency were measured pre and post-treatment. Results: The mean age of participants was 44.23 ± 4.64 and 45.3 ± 5.3 in study and control groups respectively ( P > 0.05). There were statistically significant differences in VAS, ODI, and H-reflex latency in favor of the study group ( P < 0.05). The mean ± SD for VAS, ODI, and H-reflex latency pre vs post treatment was 6.13 ± 1.22 vs 1.40 ± 0.77, 64.46 ± 4.05 vs 16.86 ± 2.55, and 32.07 ± 2.76 vs 27.46 ±1.79 in study group and 5.86 ± 1.07 vs 2.46 ± 0.73, 63.93 ± 3.91 vs 23.40 ± 2.93, and 31.76 ± 2.69 vs 29.4 ± 1.94 in control group, respectively. Conclusions: Neural mobilization combined with traditional physical therapy program achieved better improvement in pain, functional disability and H-reflex in patients who underwent decompressive laminectomy than traditional physical therapy program only.

2019 ◽  
Vol 5 (4) ◽  
pp. 57
Author(s):  
I.A. Sasko ◽  
O.V. Beziazychna ◽  
S.V. Manucharian

<p><strong>Objective:</strong> to develop and experimentally explain physical therapy methods for vertebrogenic lumbosacral pain.</p><p><strong>Material and methods:</strong> 20 young men having vertebrogenic lumbosacral pain took part in the experiment at training motor mode, they were divided into two groups – experimental and control one, containing 10 people each. Men in experimental group had physical therapy according to original program, men from the control group – did it according to common recommendation of the Ministry of Health of Ukraine. Pedagogical and medico-biological studies have been carried out since October 2019 up to December 2019. Physical therapy courses in both experimental and control group lasted for two months. Clinical methods (medical history, visual examination), assessment according to Visual Analogue Scale of pain (VAS), lumbar spine mobility investigation, life quality evaluation according to Oswes  try Disability Index questionnaire.</p><p><strong>Results:</strong> The presented efficiency of physical therapy program for training motor mode using the exercises on Redcord Suspension System: dynamic exercises to improve spine mobility, static exercises to strengthen and improve core and lower extremity muscles endurance, exercises using slings to improve proprioception; therapeutic massage according to Yefimenko methods: massage of lumbosacral region of spine, glutes, favorable number of procedures – is 15-20 ones; instrumental physiotherapy methods: ultrasound (1.2 – 1.4 W-cm<sup>2</sup>), double-pole interference (25-27 mA), Trabert’s current (7-8-12 mA).</p><p><strong>Conclusions</strong>: In the course of study undertaken we have made a conclusion that physical therapy program developed and introduced at the premises of Kinezio Medical Center of Physical Rehabilitation and Sport Medicine in Kharkov for young men having vertebrogenic lumbosacral pain allowed advancing efficiency of medical rehabilitation, is accessible for all specialized rehabilitation facilities and appears worthy of practical application.</p>


1992 ◽  
Vol 107 (5) ◽  
pp. 638-643 ◽  
Author(s):  
Helen Cohen

Vertigo caused by vestibular disorder may be successfully treated with a physical therapy program of graded exercises to habituate the patient to the vertiginous stimulus and to increase the range of motion through which the patient can tolerate moving. Performance on daily self-care tasks is an important indicator of the patient's tolerance for head movement and the success of treatment. In this study, self-care skill in subjects with labyrinthine and brainstem lesions before and after receiving vestibular rehabilitation was examined. Subjects improved significantly after physical therapy, demonstrating greater independence in their abilities to care for themselves. These data provide further support for the value of vestibular rehabilitation procedures.


Author(s):  
Salah Abd Elmonem Sawan ◽  
Abdelazim M. Reda ◽  
Ahmed Hosny Kamel ◽  
Mennat Allah Mohamed Ali

Abstract Background Transcranial direct current stimulation (tDCS) may have a potential for improving post-stroke dysphagia. Objective The purpose of this study was to examine the effect of tDCS on improving dysphagia in stroke patients. Patients and methods Forty stroke patients were divided randomly into two equal groups (the study (group A) and control groups (group B). Group A received a physical therapy program and active (tDCS), and group B received the same physical therapy program and sham (tDCS). The Dysphagia Outcome and Severity Scale (DOSS) and videofluoroscopy were performed in all patients before and after 2 weeks of the treatment program. Results Before treatment, there were no significant differences between the two groups for DOSS score or digital fluoroscopic findings. After treatment, there were significant differences between the study and control group for DOSS score and digital fluoroscopic findings. Conclusion Anodal tDCS is effective in improving dysphagia in stroke patients.


2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Mohamed Ali Elshafey ◽  
Adel Abd-Elaziem ◽  
Rana Elmarzouki Gouda

Objective.Studying the effect of the functional stretching exercise in diplegic children.Design.Children were randomly assigned into two matched groups.Setting.Outpatient Clinic of the Faculty of Physical Therapy, Cairo University.Participants.Thirty ambulant spastic diplegic children, ranging in age from five to eight years, participated in this study.Interventions.The control group received physical therapy program with traditional passive stretching exercises. The study group received physical therapy program with functional stretching exercises. The treatment was performed for two hours per session, three times weekly for three successive months.Main Outcome Measure(s).H∖M ratio, popliteal angle, and gait parameters were evaluated for both groups before and after treatment.Results.There was significant improvement in all the measuring variables for both groups in favor of study group. H∖M ratio was reduced, popliteal angle was increased, and gait was improved.Conclusion(s).Functional stretching exercises were effectively used in rehabilitation of spastic diplegic children; it reduced H∖M ratio, increased popliteal angle, and improved gait.


2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Raheel Sanad ◽  
Shimaa Mohamed Refaat ◽  
Faten Hassan Abdelazeim ◽  
Bassant Meligy

Abstract Background Cough assist devices play an important role with patients in the intensive care unit (ICU), particularly those with neuromuscular diseases which had abnormal muscle tone. It was previously thought to be the main technique for improving cough efficacy, which aids in weaning from mechanical ventilation and improves patient outcomes. So, we selected randomly the odd numbers from Abo El-Reesh hospital records, and 30 children of both sexes with pneumonia were selected, aged from 6 months to 3 years, who were selected from intensive care unit: fifteen children were the control group, who received the selected physical therapy program (postural drainage, percussion and resist diaphragm), and another fifteen children were the study group, who received previous physical therapy program, which was selected, and cough assist device. Results This study revealed the effect of cough assist device on blood gasses and the period of mechanical ventilator on children with pneumonia and general hypotonia. There was a significant decrease in pH, PaCO2, and HCO3 post treatment compared with that pretreatment in the study and control groups (p < 0.05). The percentage of decrease in pH, PaCO2, and HCO3 in study group A were 0.4, 38.26, and 30.28% respectively while that in the control group were 0.4, 32.56, and 25.48% for pH, PaCO2, and HCO3 respectively. There was a significant increase in PaO2 post treatment compared with that pretreatment in the study and control groups (p < 0.001). The percentage of increase in PaO2 in the study group was 32.13% and that in control group was 30.09%. There was no significant difference in pH, PaCO2, and HCO3 between both groups pre-treatment (p ˃ 0.05). Also, there was no significant difference between groups post treatment (p ˃ 0.05). The median (IQR) period of mechanical ventilation in the study group was 5 (7, 4) days while that in control group was 8 (18, 5) days. There was a significant decrease in period of mechanical ventilator of the study group compared with that of control group (p = 0.03). Conclusion The cough assist device and physical therapy program were selected for children in the intensive care unit which have the same effect on arterial blood gasses as they optimize pH, PO2, PCO2, and HCO3, but the cough assist device helps in accelerating weaning of mechanical ventilator so as decrease the period of mechanical ventilator.


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