Rehabilitation results in patients after operation of discopathy in lumbo-sacral section

Teresa Pop, Krzysztof Kołodziej, Maria Pabis, Grzegorz Przysada, Piotr Szpunar

Teresa Pop, Krzysztof Kołodziej, Maria Pabis, Grzegorz Przysada, Piotr Szpunar – Rehabilitation results in patients after operation of discopathy in lumbo-sacral section. Fizjoterapia Polska 2002; 2(4); 280-284

Abstract
Background. In results from data in literature and our observations that 2% of patients with the low back pain requires operational treatment. The work presents algorithm of rehabilitation of patients after the operation of removing the nucleus pulposus in the lumbosacral section. Material and methods. Twenty patients were examined, who in a period of November 2000 till March 2001 were operated at the Neurosergical Department and rehabilitated in the Physiotherapy Laboratory of the Rehabilitation Department of the District Hospital No. 2 in Rzeszów. In order to evaluate pain a visual analogue scale VAS and five-points Likert’s scale were used. The examination was performed three times: before and after the surgery and after a three weeks’ period of rehabilitation. Results and conclusions. The algorithm of procedure in the post-surgery period was proposed, in which complex rehabilitation was taken into consideration, among others physiotherapy, psychotherapy, pharmacotheraphy, professional advising, teaching ergonomy of labour and rest.

Key words:
discopathy, Low Back Pain, nucleus pulposus, Likert’s scale

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The mobility of the lumbar spine in persons with low back pain

Arletta Hawrylak, Tadeusz Skolimowski, Katarzyna Barczyk, Dorota Wójtowicz

Arletta Hawrylak, Tadeusz Skolimowski, Katarzyna Barczyk, Dorota Wójtowicz – The mobility of the lumbar spine in persons with low back pain. Fizjoterapia Polska 2004; 4(2); 100-106

Abstract

Background. The purpose of our study was to examine changes in the mobility of the lumbar spine in persons with L5-S1 diskopathy and the changes in mobility associated with different modalities of treatment. Material and methods. We studied 150 persons 40-50 years of age, 64 men and 86 women. Due to variations in management the material was divided into two groups: Group I, treated only pharmacologically, and Group II, treated with both pharmacological methods and physiotherapy. The patients were examined twice, once before treatment and again after 6 weeks of treatment. The research methods included clinical interviews and measurement of thoraco-lumbar and lumbar mobility on all planes. Non-steroid anti-inflammatory drugs were used in Group I. In Group II, comprehensive physiotherapy was also applied, including physicotherapy, kinesitherapy, and massage. Results. Our analysis of the material showed that the limitations in spinal mobility were similar in both groups at baseline. After a 6-week course of treatment, significant improvement in the mobility of the thoraco-lumbar and lumbar spine was noted only in Group II (pharmacotherapy and physiotherapy), involving all the tested ranges of movement. Conclusions. An evaluation of treatment outcome in persons with L5-S1 diskopathy indicates that persons treated both with pharmacotherapy and physiotherapy show greater improvement. The fact that significant improvement was seen only in this group may result from the fact that the drugs used prepared the way for better results in subsequent physiotherapy. These results indicate that pharmacological treatment in these patients should be supplemented with physiotherapy.

Key words:
discopathy, non-steroidal anti-inflammatory drugs, physicotherapy, kinesitherapy, massage
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The analgesis effectiveness of continuous and fractionated doses of laser radiation in the rehabilitation of patients with chronic pain syndrome in the lumbo-sacral spine

Jolanta Kujawa, Anna Cink, Kamila Gowrys, Ireneusz Pieszyński, Jan Talar

Jolanta Kujawa, Anna Cink, Kamila Gowrys, Ireneusz Pieszyński, Jan Talar – The analgesis effectiveness of continuous and fractionated doses of laser radiation in the rehabilitation of patients with chronic pain syndrome in the lumbo-sacral spine. Fizjoterapia Polska 2004; 4(3); 237-244

Abstract

Background. Due to the complex etiopathogenesis and the diversity of treatment approaches, spinal pain syndromes constitute a serious medical problem. The chronic pain and functional disturbances accompanying discopathy have motivated a search for more effective physiotherapeutic methods, such as McKenzie’s method of biomechanical diagnosis and treatment and laser therapy. The goal of the present study was to evaluate the analgesic effectiveness of continuous and fractionated doses of laser radiation in chronic lumbo-sacral pain syndrome. Material and methods. Our research involved 88 patients with chronic spinal pain syndrome qualified for McKenzie kinesitherapy. All subjects received kinesitherapy according to the authors’ method, selected according to the biomechanical diagnosis, along with 10 laser therapy procedures. Group A (43 patients) received a continuous dose of 9 J per point, while Group B (45 patients) received a fractionated dose of 3J + 6J per point. 37 points in the lumbo-sacral region were irradiated. Results. Group B showed a significantly greater decrease in pain intensity on the VAS scale (0-10 points), and in pain frequency. Both groups were found to have a reduced deficit in range of movement according to the McKenzie Institute lumbar checklist. Conclusions. Laser therapy with fractionated doses proved to be more effective in pain relief than continuous doses. The method of dosing laser radiation had no effect on improved range of movement in the lumbar spine. Biomechanical treatment using the McKenzie method combined with laser therapy significantly reduces pain and improves the range of movement in patients with chronic lumbar pain syndrome.

Key words:
discopathy, McKenzie method, kinesitherapy, biomechanical diagnostics
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The use of elongation angle measurments in evaluation of lumbar spine mobility in patients treated for lumbar discopathy

Waldemar Mieszała, Juliusz Migasiewicz, Ewaryst Jaskólski, Krystyna Chromik, Wiesław Błach

Waldemar Mieszała, Juliusz Migasiewicz, Ewaryst Jaskólski, Krystyna Chromik, Wiesław Błach – The use of elongation angle measurments in evaluation of lumbar spine mobility in patients treated for lumbar discopathy. Fizjoterapia Polska 2007; 7(1); 10-14

Abstract

Background. The article describes diagnostic tests which examine lumbar spine mobility in persons treated for discopathy. The aim of the paper was to monitor lumbar spine mobility in persons treated for lumbar discopathy to study the usefulness of combined physiotherapy sessions, isometric exercises and postisometric muscle relaxation. Material and methods. The study participants were 60 men aged 40-45 years who suffered from chronic spinal ailments. In all patients the main reason for the complaints was lumbar intervertebral disc disorder. Elongation angle measurments were performed with use of „Posturometer S” – computerised set for tridimensional evaluation of examined antropometric points. Results and Conclusions. The analysis of subjective pain evaluation revealed that the effects were similar in both examined groups. Analysis of results indicates significant and positive influence of the implemented kinesitherapy on increase of mobility in examined spinal segment.

Key words:
elongation, kinesitherapy, discopathy
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Trunk asymmetry in people with L5-S1 lumbar discopathy

Arletta Hawrylak, Tadeusz Skolimowski, Katarzyna Barczyk, Barbara Ratajczak

Arletta Hawrylak, Tadeusz Skolimowski, Katarzyna Barczyk, Barbara Ratajczak – Trunk asymmetry in people with L5-S1 lumbar discopathy. Fizjoterapia Polska 2008; 8(1); 11-22

Abstract
Background. The aim of this study was to investigate and describe trunk symmetry patterns via an analysis of changes in the position of selected anthropometric points and tracing these changes in time relative to type of treatment. Material and methods. The study enrolled 150 people aged 40-50 diagnosed with a chronic spinal pain syndrome inthe course of L5-S1 discopathy. The patients were divided into two groups corresponding to different treatments used. Patients in each group were further divided with respect to the direction of the hemia of the nucleus pulpous. Examinations were carried out twice: before starting treatment and after 6 weeks. Results. The degree of asymmetry in the frontal plane was similar between the study groups. Asymmetry occurred in a considerable percentage of the patients in both groups. Conclusions. Greater improvement of the asymmetry was noted in the patients receiving combination treatment, which may indicate a need for combining physiotherapy with pharmacological treatment in the treatment of discopathy. A complete cure is difficult to obtain in lumbar discopathy patients following a 6-week treatment. Long-term thearpy is needed as well as broadly understood prophylaxis to prevent recurrence of symptoms.
Key words:
discopathy, Moire Topography, physical therapy, kinesitherapy, massage
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Transcutaneous electrical nerve stimulation in low back pain treatment

Barbara Ratajczak, Ewa Boerner, Arletta Hawrylak, Aneta Demidaś

Barbara Ratajczak, Ewa Boerner, Arletta Hawrylak, Aneta Demidaś – Transcutaneous electrical nerve stimulation in low back pain treatment. Fizjoterapia Polska 2008; 8(2); 179-188

Abstract
Background. The aim of this study was to assess the effectiveness of TENS and its impact on pain intensity, mobility range and functional capacity of the spine in subjects with a diagnosed lumbar discopathy. Material and methods. The study group consisted of 40 patients with a diagnosed lumbar discopathy. This group was subjected to TENS therapy. The intensity of pain, functional status and mobility range of the lumbar spine in the sagittal, frontal and transverse planes were assessed in all patients before and after the therapy.Results. The results indicate that functional capacity correlates significantly with pain level. The sensation of pain is the main determinant of patients’ physical and mental well-being. It is reflected both in differences in pain level owing to TENS (the patients’ physical and mental state was getting better along with decreasing pain level) and in the values of this parameter before and after the TENS therapy. The observed differences were statistically significant, allowing the conclusion that functional capacity correlates significantly with pain intensity.Conclusion. Pain intensity decreased considerably under the influence of TENS, which also had a marked effect on increasing lumbar flexion range in the sagittal plane. The patient’s functional capacity improved significantly with TENS and, consequently, so did their general physical and mental well-being.
Key words:
discopathy, transcutaneus electrical nerve stimulation, pain, functional fitness test
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