scholarly journals Efficacy of lumbar kinetic chain training for staged rehabilitation after percutaneous endoscopic lumbar discectomy

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Zhen Lyu ◽  
Jinzhu Bai ◽  
Shizheng Chen ◽  
Jiesheng Liu ◽  
Wenlong Yu

Abstract Background Percutaneous endoscopic lumbar discectomy (PELD) is a promising minimally invasive treatment for lumbar disc herniation (LDH). Postoperative rehabilitation can improve patient outcomes. Not only rehabilitation for surgical trauma but also rehabilitation for lumbar spine and lower kinetic chain dysfunction should be performed. The aims of this study were to investigate the efficacy of a lumbar kinetic chain training for staged rehabilitation after PELD for LDH. Methods Fifty one LDH patients treated with PELD were studied. After surgery, patients underwent lumbar kinetic chain training for staged rehabilitation( staged group) or regular low back rehabilitation (regular group). The staged rehabilitation programme included three phases from 2 to 6, 7–12, and 13–24 weeks postoperatively, and different physical therapies were performed during these phases. The low back pain visual analogue scale (VAS), JOA score, ODI, SF-36, and cross-sectional area of the lumbar multifidus on MRI were assessed, and gait analysis was performed. Results Twenty five patients in staged group and twenty six patients in regular group were included. There were no significant differences in age or sex between the two groups at baseline (p > 0.05). The VAS score decreased and the JOA and SF-36 scores increased in both groups from baseline to 6 weeks (P < 0.05). In the staged group, compared with the regular group, the VAS and ODI scores were lower and the JOA and SF-36 scores were higher at 6 weeks (P < 0.05); the VAS and ODI scores were lower and the SF-36 score was higher at 12 weeks (P < 0.05); the SF-36 score was higher at 24 weeks (P < 0.05); the cross-sectional area of the lumbar multifidus showed no differences at 12 weeks (P > 0.05); and the left-right support ratio of gait was higher at 24 weeks (P < 0.05). Conclusions The staged rehabilitation programme for LDH after PELD promoted postoperative recovery, and the efficacy of lumbar kinetic chain training was higher than that of regular low back muscle exercise.

2021 ◽  
Author(s):  
Zhen Lyu ◽  
Jinzhu Bai ◽  
Shizheng Chen ◽  
Jiesheng Liu ◽  
Wenlong Yu

Abstract Background Percutaneous endoscopic lumbar discectomy (PELD) is a promising minimally invasive treatment for lumbar disc herniation (LDH). Postoperative rehabilitation can improve patient outcomes. Not only rehabilitation for surgical trauma but also rehabilitation for lumbar spine and lower kinetic chain dysfunction should be performed. The aims of this study were to investigate the efficacy of a lumbar kinetic chain training for staged rehabilitation after PELD for LDH. Methods Sixty LDH patients treated with PELD were retrospectively studied. After surgery, patients underwent lumbar kinetic chain training for staged rehabilitation( staged group) or regular low back rehabilitation (regular group). The staged rehabilitation programme included three phases from 2–6, 7–12, and 13–24 weeks postoperatively, and different physical therapies were performed during these phases. The low back pain visual analogue scale (VAS), JOA score, ODI, SF-36, and cross-sectional area of the lumbar multifidus on MRI were assessed, and gait analysis was performed. Results Thirty patients in each group were included. There were no significant differences in age or sex between the two groups at baseline (p > 0.05). The VAS score decreased and the JOA and SF-36 scores increased in both groups from baseline to 6 weeks (P < 0.05). In the staged group, compared with the regular group, the VAS and ODI scores were lower and the JOA and SF-36 scores were higher at 6 weeks (P < 0.05); the VAS and ODI scores were lower and the SF-36 score was higher at 12 weeks (P < 0.05); the SF-36 score was higher at 24 weeks (P < 0.05); the cross-sectional area of the lumbar multifidus showed no differences at 12 weeks (P > 0.05); and the left-right support ratio of gait was higher at 24 weeks (P < 0.05). Conclusions The staged rehabilitation programme for LDH after PELD promoted postoperative recovery, and the efficacy of lumbar kinetic chain training was higher than that of regular low back muscle exercise.


2021 ◽  
Author(s):  
Sarafadeen Raheem ◽  
Sokunbi O. Ganiyu ◽  
Aminu A. Ibrahim ◽  
Anas Ismail ◽  
Mukadas O. Akindele ◽  
...  

Abstract Background: Impairments in the lumbar multifidus muscle such as reduced muscle thickness and fat infiltrations are evident in individuals with low back pain. Lumbar stabilization exercises (LSE) with real-time ultrasound imaging (RUSI) biofeedback has been reported to improve preferential activation of as well as retention in the ability to activate of the lumbar multifidus muscle, thus enhancing recovery. However, the effects of using this treatment approach in individuals with nonspecific chronic low back pain (NCLBP) seemed not to have widely reported. The purpose of this study is, therefore, to investigate the effects of LSE with RUSI biofeedback on lumbar multifidus muscle cross-sectional area in individuals with NCLBP patients. Method: This study is a prospective, single-center, assessor-blind three-arm, randomized controlled to be conducted at National Orthopedic Hospital, Kano State, Nigeria. Ninety-one individuals with NCLBP will be randomly assigned into one of the three treatment groups of equal sample size (n = 30); LSE group, LSE with RUSI biofeedback group, or control (minimal intervention). The participants in the LSE and LSE with RUSI biofeedback group will also receive the same intervention as the control group. All participants will receive treatment twice weekly for 8 weeks. The primary outcome will be lumbar multifidus muscles cross-sectional area while the secondary outcomes will be pain, functional disability and quality of life. All outcomes will be assessed at baseline, and at 8 weeks and 3 months post-intervention.Discussion: The outcome of the study may support the evidence for the effectiveness of LSE with RUSI biofeedback in the rehabilitation of individuals with NCLBP. It may also provide a rationale for the physiotherapists to make use of diagnostic ultrasound as a feedback mechanism in enhancing the performance and retention of LSE program as well as monitoring the patient’s recovery.Trial registration: Pan African Clinical Trials Registry, (PACTR201801002980602), Registered on 16 January 2018.


Trials ◽  
2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Raheem Sarafadeen ◽  
Sokunbi O. Ganiyu ◽  
Aminu A. Ibrahim ◽  
Anas Ismail ◽  
Mukadas O. Akindele ◽  
...  

Abstract Background Structural impairment of the lumbar multifidus muscle, such as reduced cross-sectional area, is evident among individuals with chronic low back pain. Real-time ultrasound imaging (RUSI) biofeedback has been reported to improve preferential activation of as well as retention in the ability to activate the lumbar multifidus muscle during lumbar stabilization exercises (LSE). However, evidence of the effectiveness of this treatment approach in individuals with non-specific chronic low back pain (NCLBP) is still limited. The purpose of this study is, therefore, to determine the effectiveness of LSE with RUSI biofeedback on lumbar multifidus muscle cross-sectional area in individuals with NCLBP. Methods/Design This study is a prospective, single-center, assessor-blind, three-arm, parallel randomized controlled trial to be conducted at National Orthopedic Hospital, Kano State, Nigeria. Ninety individuals with NCLBP will be randomized in a 1:1:1: ratio to receive LSE, LSE with RUSI biofeedback, or minimal intervention. All participants will receive treatment twice weekly for 8 weeks. The primary outcome will be the lumbar multifidus muscle cross-sectional area. The secondary outcomes will include pain (Numerical Pain Rating Scale), functional disability (Roland–Morris Disability Questionnaire), and quality of life (12-Item Short-Form Health Survey). All outcomes will be assessed at baseline, 8 weeks post-intervention,  and 3 months follow-up. Discussion To our knowledge, this study will be the first powered randomized controlled trial to compare the effectiveness of LSE training with and without RUSI biofeedback in individuals with NCLBP. The outcome of the study may provide evidence for the effectiveness of LSE with RUSI biofeedback on enhancing the recovery of the lumbar multifidus muscle in individuals with NCLBP. Trial registration Pan African Clinical Trials Registry (PACTR201801002980602). Registered on January 16, 2018.


Spine ◽  
2012 ◽  
Vol 37 (26) ◽  
pp. E1651-E1658 ◽  
Author(s):  
Martin J. Willemink ◽  
Hendrik W. van Es ◽  
Pieter H. Helmhout ◽  
Arjen L. Diederik ◽  
Johannes C. Kelder ◽  
...  

2015 ◽  
Vol 137 (7) ◽  
Author(s):  
Celal Gungor ◽  
Ruoliang Tang ◽  
Richard F. Sesek ◽  
Kenneth Bo Foreman ◽  
Sean Gallagher ◽  
...  

Accurate and reliable “individualized” low back erector spinae muscle (ESM) data are of importance to estimate its force producing capacity. Knowing the force producing capacity, along with spinal loading, enhances the understanding of low back injury mechanisms. The objective of this study was to build regression models to estimate the ESM cross-sectional area (CSA). Measurements were taken from axial-oblique magnetic resonance imaging (MRI) scans of a large historical population [54 females and 53 males at L3/L4, 50 females and 44 males at L4/L5, and 41 females and 35 males at L5/S1 levels]. Results suggest that an individual's ESM CSA can be accurately estimated based on his/her gender, height, and weight. Results further show that there is no significant difference between the measured and estimated ESM CSAs, and expected absolute error is less than 15%.


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