Comparison between effect of dynamic neuromuscular stabilisation (dns) and canal enlargement exercises in individuals with lumbar canal stenosis

BACKGROUND

Lumbar spinal stenosis is degenerative condition of the spine and major cause of low back pain. The prevalence of the lumbar canal stenosis is increasing progressively, majority of population from young age group to old age group is affected with low back pain. The various treatment approaches is available for lumbar spinal stenosis such as medical treatment, Epidural corticosteroid, spinal surgery, physiotherapy treatment.The treatment for lumbar canal stenosis is mostly surgical. Few researchers introduce non surgical methods which help in better outcome. One of new method developed by Prague School of Rehabilitation is Dynamic Neuromuscular Stabilization (DNS) approach which will produce eccentric contraction of transverse abdominis muscle and increase intraabdominal pressure. Intra-abdominal pressure & integrated spinal stabilizing system provide functional spinal stability which will help in better outcome in individuals with lumbar canal stenosis.

OBJECTIVE

To find the effectiveness of Dynamic Neuromuscular Stabilization and canal enlargement exercises in lumbar canal Stenosis.

METHODOLOGY

Nature of study

The present study will be Randomized Control Trial (RCT) in nature in which Comparison between effect of Dynamic Neuromuscular Stabilization and Canal enlargement exercises in individuals with lumbar canal stenosis will be seen

Sampling Method

Purposive Sampling will be done.

Sample Size

A total of 20 subjects will be selected for the study and the same will be equally allocated into the both groups.

Sampling Criteria

Inclusion Criteria

Exclusion Criteria

|·        Individuals with age group 20-60 years

·        MRI findings with lumbar canal spinal stenosis

·        Pain in lumbopelvic region and in lower extremities

·        Individuals diagnosed with lumbar canal spinal stenosis

·        Previous lumbar spinal surgery, Recent surgical cases

·        H/O spinal tumors, infections, lumbar vertebra fracture

·        Structural stenosis

·        Non cooperative individuals

·        Pregnancy

·        Individuals with severe vascular, pulmonary or coronary artery diseases

·        Individuals with Psychological disorders

 Outcome Measures: Oswestry Low Back Pain Disability Questionnaire**,** Numerical Pain Rating Scale , The Neurogenic Claudication outcome Score, H-reflex

Procedure

Participants will be selected from the population on the basis of inclusion and exclusion criteria. Participants will be explained about the nature of the study and consent will be signed by the participants. Assessment will be done by using Oswestry Low Back Pain Disability Questionnaire, Numerical Pain Rating Scale and The Neurogenic Claudication outcome Score. The treatment protocol of 45 min/day for 5 days a week for a period of 3 weeks will be given.

Step 1:

The participants will be asked to wear comfortable clothing and to remove metallic ornament during treatment session. The participants will be made to lie supine comfortably on couch. The treatment will be started.

Step 2:

A proper assessment will be taken on Day 0, Day 5, Day 10  Oswestry Low Back Pain Disability Questionnaire will be filled by the patient followed by, The Neurogenic Claudication outcome  Score, Numerical Pain Rating Scale, H-reflex, reading will be taken in data collection form.

For the Experimental group (A)

Step 3:

Participants will treated with Dynamic Neuromuscular Stabilization exercises, TENS, Hot fomentation, Static bicycling, balance training, Class-IV LASER

Step 4:

The Data will be collected on Pre Intervention i.e. Day 0, post intervention Day 12 & Day 21. Collected data will be analyzed for the study.

For the Experimental group (B)

Step 3:

In this group participants will be treated with Canal enlargement exercises, TENS, hot fomentation, static bicycling, balance training, class-IV LASER,.

Step 4:

The Data will be collected on pre intervention i.e. Day 0, post intervention Day 12 & Day 21. Collected data will be analysed for the study.