Comparison of Effectiveness of Passive Hamstring Stretching Technique and Neurodynamic Sciatic Nerve Sliding Technique in Low Back Pain

Objective: Low back pain (LBP) is a very common health problem worldwide having global point prevalence of 9.4%. Correlations have been found between decreased length of the hamstrings and LBP. It was found that improving the flexibility of hamstrings can significantly reduce chronic LBP. This study compared the effectiveness of two techniques i.e. passive hamstring stretching technique (PHS) and neurodynamic sciatic nerve sliding technique (NDS) on hamstring flexibility and pain in non-radiating LBP patients. Methods: 26 patients between the age group of 25-45 years having non-radiating LBP were recruited in the study. Group A (n=13) were given passive hamstring stretching while Group B (n=13) performed neurodynamic sciatic nerve sliding technique under guidance of the researcher. Baseline data were obtained for hamstring length and pain before and after intervention. Pain was assessed using ‘visual analogue scale’ and hamstring length was measured using ‘passive knee extension test’. Intervention was performed on alternate days for three sessions with 48 hours rest period in between each session. Results: Data were analysed for hamstring length and pain between both the groups using ‘unpaired t’ test. NDS technique was statistically significantly more effective in improving pain (p =0.03 at 95%CI= -2.07 to -0.09). There was no statistically significant difference in the effectiveness of both techniques in improving hamstring length (p =0.08 at 95%CI= -3.4 to 0.25). Conclusions: Both the techniques are equally effective in improving hamstring length, however NDS was more effective in improving pain in low back pain patients as compared to PHS. Keywords: Low back pain; Neural sliders; Static hamstring stretch; Hamstring flexibility .

LOW BACK PAIN AND ITS ASSOCIATED FACTORS AMONG SECONDARY SCHOOL TEACHERS IN CUTTACK, ODISHA: A CROSS-SECTIONAL STUDY

The purpose of the present study was to search the prevalence of low back pain and its associated factors in secondary school teachers of Cuttack, Odisha. For this purpose, 457 secondary school’s teachers aged 26-60 years were contacted from various schools of Cuttack city, of those 191 teachers (76 male and 115 female) were confirmed for low back pain by self- informative questionnaire. Modified Oswestry Low Back Pain Disability Pain Questionnaire and a self-constructed questionnaire were applied to measure the socio-demographic and economic characteristics of the participants. The results revealed that the overall prevalence of LBP in the last 12 months among secondary school teachers was 41.79%, of those female teachers (60.20%) were affected more than their male counterparts. Some factors, such as excessive work load, sleeping disturbance (especially in female teachers), prolonged standing in classroom, physical inactivity affected adversely towards their health and wellbeing causing LBP in them. It was also found that the maximum male (75.00%) and female (58.26%) teachers had the minimum disability in Oswestry Disability Index category. It might be concluded that the addressing work-related and individual factors would be essential to decrease the magnitude of the problem. Keywords: Low back pain, Prevalence, Associated factors, Secondary school teachers of Cuttack, Odisha.

AYURVEDA UNDERSTANDING OF KATISHULA (LOW BACK PAIN) AS A VYADHI OR LAKSHANA: A HISTORICAL REVIEW

Low back pain is a very common health problem worldwide and a major cause of disability affecting performance at work and general well-being. Though several risk factors have been identified including occupational posture, depressive moods, obesity, body height and age, the causes of the onset of low back pain remain obscure and di- agnosis difficult to make. Low back pain affects people of all ages, from children to the elderly, and is a very fre- quent reason for medical consultations. The 2010 Global Burden of Disease Study estimated that low back pain is among the top 10 diseases. Prevalence increases and peaks between the ages of 35 years and 55 years. Katishula or Low back pain is one of the Vataja Nanatmaja vikaras. The symptoms of Katishula explained in the Classics when compared to Low back pain almost appear similar, so we can co-relate Katishula with Low back pain. Many a times in our clinical practice we come across patients complaining of Katishula (low back pain) as a common symptom which can be seen in many of the diseases with different way of presentation based on the se- verity of the condition. Hence the Present article is built on a detailed historical search on Katishula as per the various classical references, in understanding it merely as a symptom or the disease proper. Keywords: Low back pain, Katishula, Vataja nanatmaja vikara.

Modern patient management with low back pain

Low back pain (LBP) is one of the most common pathologies of the musculoskeletal system worldwide. The article presents data on the main causes of LBP (mechanical, non-mechanical and visceral), the importance of differential diagnosis concerning possible causal factors, taking into account the presence of so-called red and yellow flags. The article also notes the fact of increased pain in the lower back and neck revealed in a number of studies in the conditions of COVID-19 and lists the main possible causes of this phenomenon. The expediency of an integrated approach to patient management with acute and chronic LBP, given the principles of evidence-based medicine, is substantiated. Drug therapy means are characterized, and data are presented indicating complex drugs’ efficacy, including those based on NSAIDs with a proven analgesic effect (diclofenac) and B vitamins. The importance of maintaining the physical activity of patients with both acute and chronic LBP and the ability of some non-pharmacological pain therapy methods (manual therapy, Kinesio taping, etc.) to reduce pain and fear of movement are noted. KEYWORDS: low back pain, red flags, differential diagnosis, treatment, NSAIDs, B vitamins. FOR CITATION: Pizova N.V. Modern patient management with low back pain. Russian Medical Inquiry. 2021;5(10):659–667 (in Russ.). DOI: 10.32364/2587-6821-2021-5-10-659-667.

Penatalaksanaan Fisioterapi Pada Kasus Low Back Pain (LBP) Akibat Hernia Nucleus Pulposus (HNP) Di Klinik Fisioterapi Karya Suci Pematangsiantar Tahun 2017

Hernia Nucleus Pulposus (HNP) is the release of the contents of the nucleus from the intervetebral disc so that the nucleus protrudes into the annular ring and provides nerve compression manifestations of muscle strength. Physiotherapy modalities that can be used to treat physiotherapy problems in the case of Hernia Nucleus Pulposus include Short Wave Diathermy (SWD) and McKenzie's exercise therapy to reduce pain, increase the scope of joint motion to increase muscle strength. To determine the implementation of physiotherapy in reducing pain, increasing the scope of joint motion, and increasing muscle strength in the case of Hernia Nucleus Pulposus (HNP) and McKenzie exercise therapy. After doing therapy for six times the result is a decrease in pain at rest T1: 6.3 to T6: 0, tenderness T1: 6.3 to T6: 1.3 motion pain T1: 6.3 to T6: 1.3. There is an increase in the range of joint motion from lumbar flexion T1: 3 cm to T6: 0 cm lumbar extension from T1: 3 cm to T6: 0 cm. Short Wave Diathermy (SWD) and McKenazie Exercise therapy exercises can reduce pain, increase the speed of motion and can increase muscle strength in the condition of Hernia Nucleus Pulposus (HNP). Keywords: low back pain (LBP); hernia nucleus pulposus (HNP); short wave diathermy (SWD); McKenzie exercise training therapy ABSTRAK Hernia Nucleus Pulposus (HNP) merupakan terjadinya pengeluaran isi nucleus dari dalam discus intervetebralis sehingga nucleus menonjol ke dalam cincin annulus dan memberikan manifestasi kompresi saraf kekuatan otot. Tujuan penelitian adalah melaksanakan modalitas fisioterapi yang dapat digunakan untuk menanngani problematika fisioterapi pada kasus Hernia Nucleus Pulposus diantaranya adalah Short Wave Diathermy (SWD) dan terapi latihan McKenzie untuk mengurangi nyeri, menambah lingkup gerak sendi meningkatkan kekuatan otot. Untuk mengetahui pelaksanaaan fisioterapi dalam mengurangi nyeri,meningkatkan lingkup gerak sendi, dan meningkatkan kekuatan otot pada kasus Hernia Nucleus Pulposus (HNP) dan terapi latihan McKenzie. Setelah dilakukan terapi selama enam kali didapat hasil adanya penurunan nyeri pada diam T1 : 6,3 menjadi T6 : 0, nyeri tekan T1 : 6,3 menjadi T6 : 1,3 nyeri gerak T1 :6,3 menjadi T6 : 1,3. Terdapat piningkatan lingkup gerak sendi dari gerak fleksi lumbal T1 : 3 cm menjadi T6: 0 cm ekstensi lumbal dari T1: 3 cm menjadi T6 : 0 cm. Short Wave Diathermy (SWD) dan terapi latihan McKenazie Exercise dapat mengurangi nyeri, menambah linggkup gerak dan dapat meningkatkan kekuatan otot pada kondisi Hernia Nucleus Pulposus (HNP). Kata kunci: low back pain (LBP); hernia nucleus pulposus (HNP); short wave diathermy (SWD); terapi latihan McKenzie Exercise

The Relationship Duration of Sitting and Work Posture Risk with LBP in Library Staff University of Jember

Low back pain (LBP) is one of the occupational diseases caused by non-ergonomic conditions. The global point prevalence of LBP which limits activity in 2015 was 7.3%. This figure shows that in one time there were 540 million people who experienced LBP. As many as 90% of cases of low back pain are not caused by organic abnormalities but by errors in body position at work. Risk factors that have the potential to cause complaints include age, gender, Body Mass Index (BMI), smoking habits, work period, poor work posture, and standing or sitting too long. This study aims to determine the relationship between duration of sitting and risk of work posture with the level of LBP complaints in Jember University library employees. The type of research used was analytic observational with cross sectional study design. The sampling technique is done by total sampling. The research samples were University Library staff in Jember who experienced LBP complaints and in accordance with the inclusion and exclusion criteria of this study. The sample size was 22 respondents. The instruments of this study were respondent characteristics questionnaire sheets, LBP screening sheets, and Modified Quick Exposure Check (QEC) assessment sheets. Bivariate analysis using the gamma correlation test. The results of the bivariate analysis between duration of sitting and LBP complaint rates obtained p = 0.827. The results of the bivariate analysis between the risk of work posture and LBP complaints were obtained p = 0.916. The two results of the analysis indicate that there is no significant relationship between the duration of sitting and the risk of work posture with the level of LBP complaints in Jember University library employees. Keywords: low back pain, duration of sitting, work posture, library staff

Acupuncture Therapy in Reducing Pain in Patients with Low Back Pain: Meta Analysis

ABSTRACT Background: With growing evidence of high prevalence in developing countries, LBP is no longer recognized as a disorder confined to high-income nations but is a major health problem globally. The functional limitations and consequent disability create a heavy economic burden on individuals and society. This study aimed to acupuncture therapy in reducing pain in patients with low back pain. Subjects and Method: A meta-analysis and systematic review was conducted by search published articles from PubMed, Google Schoolar, Mendeley, Hindawi, and Clinical key databases. Keywords used “acupuncture low back pain” OR “acupuncture chronic pain” AND “efficacy acupuncture” AND “chronic low back pain” AND “effect acupuncture for low back pain” AND “randomized controlled trial” AND “visual analogue scale”. The inclusion criteria were full text and using randomized controlled trial (RCT) study design. The articles were selected by PRISMA flow chart and the quantitative data were analyzed by Revman 5.3. Results: 7 studies were met criteria. This study showed that acupuncture therapy reduced pain in patients with low back pain (Mean Difference= -0.40; 95% CI= -0.80 to 0.01; p= 0.05) with heterogeneity I2= 83%. Conclusion: Acupuncture therapy reduces pain in patients with low back pain. Keywords: low back pain, acupuncture chronic low back pain, randomized controlled trial. Correspondence: Elisa Novitasari. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: 085727851938. DOI: https://doi.org/10.26911/the7thicph.05.43

The Effect of Tai Chi Gymnastic on Decreasing Low Back Pain of Elderly Farmers

Low back pain is one of health problems that distrub a daily comfort and activities. Low back pain increasing along with the increase of age and bent forward position which was applied in daily working by elderly farmers. The aim of this study was to analyze the effect of tai chi gymnastic on decreasing low back pain of elderly farmers. The research design of this study was one group of pre test-post test design. The population objects in this study were all of elderly farmers with low back pain complaints which were recorder in the elderly medical center, which contained of 32 samples in total and were determined using simple random sampling technique. The independent variable in this study was Tai Chi gymnastic and low back pain of elderly farmers as dependent variable. Verbal descriptor scale was used as the data collection method. This study was using editing, coding, scoring and tabulating as data processing techniques, and Wilcoxon signed rank test on testing the statistics. The result of this study showed the percentages of each low back pain phases, which contained of 41% mild low back pain, 50% moderate low back pain and 9% hard low back pain before tai chi gymnastics. Besides, the percentages of low back pain phases after tai chi gymnastic were 69% for mild low back pain, 31% moderate low back pain and 0% hard low back pain. The result of Wilcoxon signed rank test showed that the p-value = 0.001 < 0.05, so that H0 was rejected. The conclusion there was an effect of Tai chi gymnastic on decreasing low back pain of elderly farmers. Keywords: low back pain; elderly farmers; Tai chi gymnastic

Faktor-faktor yang berhubungan dengan keluhan Low Back Pain (LBP) pada pekerja pengrajin batik tulis di Kecamatan Pelayangan Kota Jambi Tahun 2018

ABSTRAK Latar Belakang : Low Back Pain (LBP) adalah salah satu gangguan muskuloskeletal akibat dari ergonomi yang salah. Angka kejadian pasti dari LBP di Indonesia bervariasi antara 7,6% sampai 37%.90% kasus LBP bukan disebabkan oleh kelainan organik, melainkan oleh kesalahan posisi tubuh dalam bekerja. Tujuan Untuk mengetahui gambaran dan hubungan posisi duduk, durasi kerja, usia, dan masa kerja dengan keluhan low back pain (LBP) pada pekerja pengrajin batik tulis di Kecamatan Pelayangan Kota Jambi Metode : Penelitian ini merupakan penelitian analitik deskriptif dengan pendekatan cross sectional yang dilakukan pada pembatik tulis di Kecamatan Pelayangan, dengan cara melakukan observasi dan wawancara. Teknik pengambilan sampel menggunakan teknik total sampling dengan jumlah sampel 36 orang yang termasuk dalam kriteria insklusi. Data dianalisis menggunakan uji chi square. Hasil : Dari penelitian ini didapatkan hasil responden yang mengalami keluhan low back pain sebesar 52,8%, 30,6% responden memiliki posisi kerja dengan risiko sangat tinggi, 86,1% responden memiliki durasi kerja lama, 91,7% responden berusia berisiko dan 88,9% responden memiliki masa kerja lama. Hasil bivariat diperoleh ada hubungan antara posisi kerja (p-value=0,007) dan masa kerja (p-value=0,04) dengan keluhan LBP. Tidak ada hubungan antara durasi kerja (p-value=0,272) dan usia (p-value=0,593) dengan keluhan LBP pada pengrajin batik tulis. Kesimpulan : bahwa ada hubungan antara posisi kerja dan masa kerja dengan keluhan low back pain pada pekerja batik tulis di Kecamatan Pelayangan Kota Jambi. Untuk itu disarankan kepada pekerja batik tulis mengatur posisi kerja yang ergonomis seperti memberi bantalan pada punggung sehingga punggung tidak membungkuk saat bekerja, menggunakan bantalan busa untuk duduk dan lain sebagainya Kata Kunci : Low Back Pain, Posisi Kerja, Durasi Kerja, Usia, Masa Kerja ABSTRACT Background : Low Back Pain (LBP) is one of the musculoskeletal disorders resulting from incorrect ergonomics. The exact incidence of LBP in Indonesia varies between 7.6% to 37%. 90% of LBP cases are not caused by organic disorders, but by errors in body position at work. Several factors related to the incidence of LBP include individual characteristics such as age, sex, body mass index (BMI), height, exercise habits, length of work and work position. Method : This study is a descriptive analytic study with a cross sectional approach conducted on batik makers in Pelayangan District, by conducting observations and interviews. The sampling technique used total sampling technique with a sample of 36 people included in the inclusion criteria. Data were analyzed using chi square test. Results : From this study, the results of respondents with low back pain complaints were 52.8%, 30.6% of respondents had very high risk positions, 86.1% of respondents had a long duration of work, 91.7% of respondents were at risk and 88 , 9% of respondents have a long working period. Bivariate results obtained there was a relationship between work position (p-value = 0.007) and work period (p-value = 0.04) with LBP complaints. There was no relationship between the duration of work (p-value = 0.272) and age (p-value = 0.593) with LBP complaints on batik makers. Conclusion : It can be concluded that there is a relationship between work position and tenure with low back pain complaints on batik workers in Pelayangan Sub-district, Jambi City. For this reason it is recommended that batik workers set ergonomic work positions such as giving a cushion on the back so that the back does not bend while working, using foam pads to sit and so on Keywords: Low Back Pain, Working Position, Work Duration, Age, Working Period

THE INTERVENTION INFRARED AND MUSCLE ENERGY TECHNIQUE AS WELL AS INFRARED AND PASSIVE STRETCHING TO DECREASE FUNCTIONAL PAINFUL OF LOW BACK PAIN MYOGENIC CONDITION

ABSTRACT The objective of the study was to find out which one is better between the interventions infrared and muscle energy technique within interventions infrared and passive stretching through the degradation of functional painful of low back pain myogenic condition. The research design that was an experimental research which was designed with pre-test and post-test group design. The sample of the study were 20 persons divided into two groups. Group 1 was given an intervention of infrared and muscle energy technique. Group 2 was given an intervention of infrared and passive stretching. Test Results hypothesis by paired sample t-test showed for group 1 was obtained a result which was p=0,000 with the vary average 4,595±3,658. For group 2 was obtained a result which was p=0,000 with the vary average 5,770±4,332. The result of the study showed a degradation pain which had a significantly in each group. For the average test, the vary between the group 1 and group 2 which used independent sample t-test were found p=0,621 (p>0,05). Based on the results of statistical tests, intervention of infrared and muscle energy technique as well as infrared and passive stretching through degradation of functional painful of low back pain myogenic condition. Keywords: Low back pain, low back pain myogenic, infrared, muscle energy technique, passive stretching, ODI.