scholarly journals Εμβιομηχανική ανάλυση βάδισης σε ασθενείς με χρόνια οσφυαλγία πριν και μετά την εφαρμογή ειδικών φυσιοθεραπευτικών τεχνικών

2015 ◽  
Author(s):  
Γεώργιος Κρεκούκιας

Εισαγωγή: οι ασθενείς που πάσχουν από χρόνια οσφυαλγία ως συνέπεια της νόσου του εκφυλισμένου δίσκου, εκτός από πόνο εμφανίζουν επίσης και διαταραχή της βάδισής τους. Ο σκοπός της μελέτης είναι η αξιολόγηση τόσο των κλινικών δεδομένων με την χρήση κλινικών κλιμάκων αξιολόγησης, όπως Oswestry Disability Index Greek version (ODI), Visual Analog Scale for low back pain and leg pain (VAS) και το Roland Morris Disability Questionnaire Greek Version, όσο και των κινητικών και κινηματικών χαρακτηριστικών κατά την ανάλυση βάδισης σε ασθενείς με χρόνια οσφυαλγία συνεπεία της νόσου του εκφυλισμένου δίσκου (Disc Degenerative Disease), πριν και μετά την εφαρμογή των ειδικών φυσιοθεραπευτικών τεχνικών (τεχνικών θεραπείας δια χειρός).Μεθοδολογία: για τις ανάγκες της μελέτης 75 ασθενείς που έπασχαν από χρόνια οσφυαλγία, χωρίστηκαν τυχαία σε 3 ομάδες των 25 η καθεμιά. Η κάθε ομάδα δέχθηκε 5 συνεδρίες που για την πρώτη ομάδα ήταν φυσικοθεραπευτικές τεχνικές δια χειρός, για τη δεύτερη ήταν εικονική θεραπεία και για την τρίτη ήταν κλασική φυσικοθεραπεία (διατατικές ασκήσεις, T.E.N.S. και μάλαξη). Προκειμένου να αξιολογηθεί η αποτελεσματικότητα της κάθε θεραπείας χρησιμοποιήθηκε η οπτική αναλογική κλίμακα του πόνου, 2 ερωτηματολόγια (Oswestry και Roland Morris) και επίσης ένα οπτικοηλεκτρονικό σύστημα καταγραφής και ανάλυσης της βάδισης (κινητικά και κινηματικά δεδομένα)Αποτελέσματα: η ομάδα που δέχθηκε τεχνικές δια χειρός εμφάνισε στατιστικά σημαντική μείωση του πόνου και των επιπέδων δυσλειτουργίας. Σε παρόμοια αποτελέσματα οδήγησε και η εφαρμογή κλασικής φυσικοθεραπείας, αλλά η ελάττωση ήταν σαφώς μικρότερη σε σχέση με την ομάδα των τεχνικών δια χειρός. Η ομάδα που δέχθηκε εικονική θεραπεία, δεν είχε κάποια στατιστικά σημαντική διαφορά στα επίπεδα πόνου και δυσλειτουργίας. Σχετικά με την αξιολόγηση της βάδισης, οι ασθενείς στο σύνολό τους, παρουσίασαν διαταραγμένη βάδιση με διαφορά στα κινητικά και κινηματικά δεδομένα μεταξύ δεξιάς και αριστερής πλευράς. Μετά την εφαρμογή των θεραπειών, μόνο η ομάδα που δέχθηκε τεχνικές δια χειρός έδειξε τάση προς συμμετρία μεταξύ δεξιάς και αριστερής πλευράς.Συμπεράσματα: σε περιπτώσεις ασθενών που πάσχουν από χρόνια οσφυαλγία συνεπεία της νόσου του εκφυλισμένου δίσκου, η εφαρμογή 5 συνεδριών τεχνικών δια χειρός δείχνει να βελτιώνει τόσο τα επίπεδα πόνου όσο και δυσλειτουργίας, καθώς επίσης και παρουσιάζει τάση προς συμμετρία στη βάδιση.

Author(s):  
Shizumasa Murata ◽  
Akihito Minamide ◽  
Yukihiro Nakagawa ◽  
Hiroshi Iwasaki ◽  
Hiroshi Taneichi ◽  
...  

Abstract Background and Study Aims Surgical treatment options for lumbar spinal stenosis (LSS) based on adjacent segment disease (ASD) after spinal fusion typically involve decompression, with or without fusion, of the adjacent segment. The clinical benefits of microendoscopic decompression for LSS based on ASD have not yet been fully elucidated. We aimed to investigate the clinical results of microendoscopic spinal decompression surgery for LSS based on ASD. Patients and Methods From 2011 to 2014, consecutive patients who underwent microendoscopic spinal decompression without fusion for LSS based on ASD were enrolled. Data of 32 patients (17 men and 15 women, with a mean age of 70.5 years) were reviewed. Japanese Orthopaedic Association score and low back pain/leg pain visual analog scale score were utilized to measure neurologic and axial pain outcomes, respectively. Additionally, after the surgeries, we analyzed the magnetic resonance imaging (MRI), computed tomography (CT) scans, or radiographs to identify any new instabilities of the decompressed segments or progression of ASD adjacent to the decompressed segments. Results The Japanese Orthopaedic Association recovery rate at the 5-year postoperative visit was 49.2%. The visual analog scale scores for low back pain and leg pain were significantly improved. The minimum clinically important difference for leg pain (decrease by ≥24 mm) and clinically important difference for low back pain (decrease by ≥38 mm) were achieved in 84% (27/32) and 72% (23/32) of cases, respectively. Regarding new instability after microendoscopic decompression, no cases had apparent spinal instability at the decompression segment and adjacent segment to the decompressed segment. Conclusions Microendoscopic spinal decompression is an effective treatment alternative for patients with LSS caused by ASD. The ability to perform neural decompression while maintaining key stabilizing structures minimizes subsequent clinical instability. The substantial clinical and economic benefits of this approach may make it a favorable alternative to performing concurrent fusion in many patients.


2014 ◽  
Vol 8 (1) ◽  
pp. 11-19 ◽  
Author(s):  
Joshua Israel Vincent ◽  
Joy Christine MacDermid ◽  
Ruby Grewal ◽  
Vincent Prabhakaran Sekar ◽  
Dinesh Balachandran

Study Design:Prospective longitudinal validation studyObjective:To translate and cross-culturally adapt the Oswestry Disability Index (ODI) to the Tamil language (ODI-T), and to evaluate its reliability and construct validity.Summary of Background Data:ODI is widely used as a disease specific questionnaire in back pain patients to evaluate pain and disability. A thorough literature search revealed that the Tamil version of the ODI has not been previously published.Methods:The ODI was translated and cross-culturally adapted to the Tamil language according to established guidelines. 30 subjects (16 women and 14 men) with a mean age of 42.7 years (S.D. 13.6; Range 22 - 69) with low back pain were recruited to assess the psychometric properties of the ODI-T Questionnaire. Patients completed the ODI-T, Roland-Morris disability questionnaire (RMDQ), VAS-pain and VAS-disability at baseline and 24-72 hours from the baseline visit.Results:The ODI-T displayed a high degree of internal consistency, with a Cronbach's alpha of 0.92. The test-retest reliability was high (n=30) with an ICC of 0.92 (95% CI, 0.84 to 0.96) and a mean re-test difference of 2.6 points lower on re-test. The ODI-T scores exhibited a strong correlation with the RMDQ scores (r = 0.82) p<0.01, VAS-P (r = 0.78) p<0.01 and VAS-D (r = 0.81) p<0.01. Moderate to low correlations were observed between the ODI-T and lumbar ROM (r = -0.27 to -0.53). All the hypotheses that were constructed apriori were supported.Conclusion:The Tamil version of the ODI Questionnaire is a valid and reliable tool that can be used to measure subjective outcomes of pain and disability in Tamil speaking patients with low back pain.


2020 ◽  
Vol 29 (7) ◽  
pp. 913-919
Author(s):  
Orges Lena ◽  
Jasemin Todri ◽  
Ardita Todri ◽  
José Luis Martínez Gil ◽  
Maria Gomez Gallego

Context: One of the main reasons why athletes with a high physical condition suffer from low back pain disease is because they often participate in sports that involve disc compression movements during flexion, lifting loads, or torsion movement. Objectives: This study aims to examine the effectiveness of the postural treatment of the Mézières method on elite rhythmic gymnastics athletes with low back pain. Design: Double-blind, randomized, controlled trial. Setting: The sports hall of “Puente Tocinos,” Murcia, Spain. Participants: Ninety gymnastics athletes were randomized into 2 parallel groups (intervention: n = 39; control: n = 51), of whom 98.9% were women (women = 89; man = 1). Intervention: The Mézières method postural therapy was implemented. It lasted about 60 minutes in repeated sessions of 2 to 3 meetings per week by counting in overall 60 sessions during a 24-week period. Main Outcome Measures: Visual analog scale of pain, sit and reach flexibility test, Runtastic (pedometer performance android application), Roland–Morris Questionnaire for the physical disability, and the Health Status Questionnaire were used. Results: The univariate analysis of variance and independent sample t test revealed a significant improvement in the intervention group concerning the visual analog scale pain assessment scale (P < .05, ), and, also, the between-groups effect size was high during the 24 sessions of treatment (d > 0.8) compared with the control one. The same situation persists even for Roland–Morris Questionnaire (P < .05, ), physical score (P < .05, ), mental score (P < .05, ), sit and reach flexibility test (P < .05, ), and Runtastic performance (P < .05, ), where the between-groups effect size was high during the 24 sessions of treatment (d > 0.8). Conclusion: The Mézières method treatment performed on athletes with low back pain has caused positive effects on all the outcomes analyzed compared with the ones of control group.


2021 ◽  
Vol 10 (8) ◽  
pp. 1781
Author(s):  
Carlos de Teresa ◽  
Alfonso Varela-López ◽  
Susana Rios-Álvarez ◽  
Rafael Gálvez ◽  
Coralie Maire ◽  
...  

Low energy pulsed electromagnetic signals (PEMS) therapy, in the field of bioelectronics, has been suggested as a promising analgesic therapy with special interest in treating conditions with poor response to pharmacotherapy. This study evaluated the effectiveness of PEMS therapy on the treatment of chronic low back pain patients with a neuropathic component. A group of 64 individuals with such condition was allocated to a 2-week treatment period (10 twenty-minute sessions on consecutive days) with an active PEMS therapy device or an inactive device in random order. The pain was assessed on a visual analog scale, and the functional status was assessed using the SF-12 questionnaire. The visual analog scale scores were lower after treatment than at baseline but only in the group treated with the active device. According to the DN4 score, neuropathic pain decreased in both experimental groups with respect to baseline, but this was only significant for the group treated with the active device. Similarly, an improvement in the SF-12 and Medical Outcomes Study (MOS) sleep scale components was reported. The study demonstrated that low-energy PEMS therapy was efficient in reducing pain and improving function in chronic low back pain patients with a neuropathic component.


2020 ◽  
Author(s):  
Jia Li ◽  
Di Zhang ◽  
Yong Shen ◽  
Xiangbei Qi

Abstract Background: The objective of the retrospective study was to investigated the incidence and risk factors of low back pain (LBP) in patients with lumbar degenerative disease after single-level oblique lateral interbody fusion(OLIF).Methods: In this retrospective study, 120 patients who undergoing single-level OLIF to treat lumbar degenerative disease were recruited. Preoperative and postoperative radiographic parameters, including segmental lordosis(SL), lumbar lordosis(LL), disk height(DH), pelvic incidence(PI), pelvic tilt (PT), sacral slope(SS), thoracic kyphosis(TK), C7-sagittal vertical axis (SVA). Visual analog scale(VAS) for back and leg pain, and Oswestry Disability Index(ODI), were used to evaluate symptoms and quantify disability. All patients achieved at least two-year follow-up.Results: A total of 120 Patients who complained low back pain were apportioned to LBP group (n=38; VAS scores for back pain≥3) or Non-LBP group (n=82;VAS scores for back pain<3). There was no difference in age(P=0.082), gender(P=0.425), body mass index(P=0.138), degenerative spondylolisthesis or lumbar spinal stenosis(P=0.529) surgical level(P=0.651), blood Loss (P=0.889) and operative time(P=0.731) between the groups. In both groups, the ODI and VAS scores for back pain and leg pain were significantly improved at the final follow-up compared to the preoperative scores (P=0.003). Furthermore, except for the LBP (P=0.000), there were no significant differences in these scores between the two groups at the final follow-up (P > 0.05). According to the radiographic parameters, in Non-LBP group, the LL, SL, DH, TK and SS had all significantly improved; PT and C7-SVA significantly decreased at the final follow-up compared to the preoperative values. The DH in both groups had significantly improved, no significant difference was found(P=0.325). In the final follow-up, LL, PI-LL, PT and C7-SVA in Non-LBP group had more improvements compared to the LBP group (P<0.05) . Multivariate analysis showed that PT, PI-LL and C7-SVA were identified as significant risk factors for LBP after OLIF.Conclusion: The clinical outcomes of OLIF for single-level lumbar degenerative disease were satisfactory. Our findings showed that PT, PI-LL mismatch and C7-SVA had the greatest impact on the incidence of LBP. Therefore, patients with appropriate decreased PT, improved C7-SVA and PI-LL match experienced less low back pain.


2020 ◽  
Author(s):  
Mario Manuel López Mesa ◽  
Javier Julian Cabrerizo Fernandez ◽  
Antonio Lopez Roman ◽  
Eva Maria Rodriguez Fernandez

Abstract Objective: The purpose was to compare the effectiveness of the Pilates Method versus the Back School in specialized care, assessing improving the disability with the Roland Morris questionnaire and the perceived pain with the visual analog scale (VAS) in people with non-specific chronic low back pain. Method: Single-blind randomized controlled trial to determine the effects of the Pilates Method for patients with low back pain compared to Back School exercises, two groups of 48 patients, 3-month treatment period. Results: The Pilates Group (GP) recorded significant improvements in all of the variables that were the subject for this research, compared to those provided by the Back School Group (GEE). In the Roland Morris questionnaire of 0,41 points [GP (Mean difference [MD] Pretreatment-posttreatment =2,08; 95% confidence interval [CI] = 1,21 to 2,95; p=0,001) vs GEE ( MD=1,66; 95% confidence interval [CI] = 0,90 to 2,43; p=0,001 )]. In the visual analog scale (VAS) of 0,40 points [ GP (Mean difference [MD] Pretreatment-posttreatment =1,82; 95% confidence interval [CI] = 1,24 to 2,40; p=0,001 ) vs GEE (MD=1,42; 95% confidence interval [CI] = 0,82 to 2,04; p=0,001)]. Conclusions: The treatment of nonspecific low back pain with therapeutic Pilates is more effective than the therapeutic treatment of the Back School, both in terms of functional disability and intensity of pain. Trial registration : This trial is registered in http://www.ensaiosclinicos.gov.br/rg/RBR-5nk2tr/ , with the ID number of RBR-5nk2tr


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