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临床试验/NCT03651440
NCT03651440已完成不适用

Effect of PNF and Lumbar Stabilization Exercises on Muscle Strength and Muscle Endurance in Patients With Lumbar Disc Hernia

Baskent University0 个研究点目标入组 64 人开始时间: 2014年5月1日最近更新:
适应症
干预措施

试验速览

阶段
不适用
状态
已完成
入组人数
64
主要终点
visual analog scale

研究概览

简要总结

Background/Objective: This study investigates the effect of lumbar stabilization and proprioceptive neuromuscular facilitation (PNF) training on muscle strength and muscle endurance.

Methods: Sixty-four participants between the ages of 15 and 69 years, graded "protrusion and bulging lumbar herniation" according to the Macnab Classification, were divided into four groups of 16: lumbar stabilization training (strength training, 5 days/week for 4 weeks); PNF training (5 days/week for 4 weeks); physical therapy (hot pack, TENS, ultrasound, 5 days/week for 4 weeks); and control (without any application). Sociodemographic features were recorded and muscle strength tested. Before and after exercise, a visual analog scale (VAS) and Oswestry Disability Index (ODI) were measured by a physical therapist. After 4 weeks, the evaluations were repeated.

Results: There were significant increases in muscle strength and muscle endurance in the lumbar stabilization group, who also showed significant improvement in pain intensity at rest and during activity, and in ODI (p<0.05). Similar results were observed in the PNF group (p<0.05), although not to the same extent. Patients undergoing physical therapy showed significant differences only in pain intensity at rest, at activity, and in ODI (p<0.05).

Conclusion: Undertaking an appropriate physiotherapy and rehabilitation program aiming to reduce waist circumference of patients with low muscle strength and low muscle endurance will help to increase muscle strength and endurance and reduce pain, and contribute toward the correction of functional disabilities.

详细描述

Lumbar disc herniation (LDH) is a clinical entity characterized by compression of the spinal nerve roots and resultant back and leg pain. Though uncommon, LDH has been reported as a cause of recurrent low back pain.

Although more than 100 risk factors have been identified for LDH, it is difficult to determine a specific etiology. The most important risk factors are intense sporting activity, heavy lifting, frequent rotation of the body, exposure to vibrations, age, tall stature, obesity, smoking, and psychological and genetic factors.

It has been shown that in LDH patients; the strength and endurance of the back and abdominal muscles are reduced, and this aspect has been reported as a major predisposing factor for low back pain. Hence, an exercise program as part of conservative treatment of low back pain and after surgery would be of potential benefit for patients. Twomey and Taylor have shown that behavioral and cognitive principles combined with exercise programs can be effective in reducing disability in patients with chronic low back pain.

The severity of symptoms in disc herniation depends not only on the amount of herniated disc pressure but also on nervous irritability. To reduce the sensitivity of nerve fibers to pain, symptomatic initiatives that include drugs, physical therapy, and psychological methods can be successful. The primary purpose of physical therapy is control of pain and inflammation, and secondarily to improve symptoms such as stiffness in the joints and muscle spasms. Physical therapy also delivers psychological effects. Agents used in physical therapy are generally administered in a combined regimen. We undertook this study to investigate the effect of lumbar stabilization training and proprioceptive neuromuscular facilitation (PNF) training on muscle strength and muscle endurance.

Results The groups showed no difference in demographic and clinical characteristics( p>0.05).

研究设计

研究类型
Interventional
分配方式
Randomized
干预模型
Crossover
主要目的
Treatment
盲法
Single (Participant)

入排标准

年龄范围
15 Years 至 69 Years(Child, Adult, Older Adult)
性别
Female
接受健康志愿者

入选标准

  • Subjects who were graded as "protrusion and bulging lumbar herniation" according to the Macnab Classification.

排除标准

  • Subjects with acute radicular signs or symptoms and those who had radiographic evidence of inflammatory disease affecting the spine, tumor, fracture, spondylolysis, spondylolisthesis, or scoliosis.

研究组 & 干预措施

lumbar stabilization training

Experimental

lumbar stabilization training exercises

干预措施: lumbar stabilization training (Other)

PNF training

Experimental

PNF training exercises

干预措施: PNF (Other)

physical therapy

Experimental

HP,TENS US

干预措施: Physical Therapy (Other)

control

Sham Comparator

NO APPLİCATİON

干预措施: Control (Other)

结局指标

主要结局

visual analog scale

时间窗: 4 weeks

. A standard visual analog scale (VAS) was a used to assess pain. The patients graded their low back pain on a 10-point scale, anchored with the descriptors "no pain" at one end and "pain as bad as it could possibly be" at the other. Maximum pain severity was assessed by a blind-testing physician using the standard VAS

次要结局

  • Oswestry Disability Index(4 weeks)

研究者

申办方类型
Other
责任方
Principal Investigator
主要研究者

Nilay Comuk Balci

associate professor

Baskent University

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