Assessment of the effectiveness of medical massage in patients with low back pain

Waldemar Andrzejewski, Krzysztof Kassolik, Anna Karaś, Grzegorz Karaś, Ewa Trzęsicka

Waldemar Andrzejewski, Krzysztof Kassolik, Anna Karaś, Grzegorz Karaś, Ewa Trzęsicka – Assessment of the effectiveness of medical massage in patients with low back pain – research report. Fizjoterapia Polska 2006; 6(2); 150-156

Abstract

Background. Low back pain is a very often reported disorder in physiotherapist’s office. Medical massage is one of the most popular method to treat this kind of problem. The main difference between medical and classical massage depends on its methodology. In medical massage it is crucial to include the structural relationship between soft tissues. In order to find an effective treatment method therapist must treat patients as a whole, as a number of connected with each other structures. To assess the effectiveness of medical massage in people with low back pain problems. Material and methods. Twenty eight patients with low back pain have taken part in the research. Anamnesis was taken from all the patients, they also had a palpation examination to evaluate the intensity of pain in tissues. The evaluation was taken before the treatment, after the sixth and the last procedure of medical massage. Patients had one set consisting of 10 procedures. Time duration of each procedure was between 40-70 minutes. It was supposed that the painful area means disorder with an increased tension in this place. Structures which had bigger tenderness were massaged. Subjects were in prone or lying on their side position in order to maintain relaxed conditions. Classical techniques were used: stroking, petrissage, kneading, and vibration by the same therapist in all subjects. Results. There has been a significant decrease in both number of painful areas and pain intensity reported by patients. Conclusion. Medical massage is an effective therapeutic method to work on patients with low back pain. The effectiveness of massage was observed after six procedures, and after the sixth massage patients reported only slight pain.

Key words:
low back pain, medical massage, pain evaluation
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Interpretation of the results of physiotherapy for low back pain based on the Ryodoraku electrodermal measurements

Andrzej Żytkowski, Henryk Chmielewski, Beata Wrodycka

Andrzej Żytkowski, Henryk Chmielewski, Beata Wrodycka – Interpretation of the results of physiotherapy for low back pain based on the Ryodoraku electrodermal measurements. Fizjoterapia Polska 2007; 7(4); 392-400

Abstract
Background. The aim of this study was to analyse skin conductance of a direct current (galvanic skin response, GSR) in dermatomes corresponding to the level of discopathy and to provide an indirect objective interpretation of several commonly used physiotherapeutic methods: low frequency diadynamic currents, medium frequency interferential currents, low frequency pulsed magnetic therapy and classic acupuncture. Material and methods. Tests of GSR, an indirect measure of sympathetic activity, were carried out in addition to clinical assessment and radiological studies in a group of 164 patients with diagnosed low back pain [65 persons with a pseudoradicular pain syndrome and 99 patients with evident sciatic neuralgia], using the diagnostic component of Yoshio Nakatani’s Ryodoraku method. The essence of the method is the measurement of skin conductance of a 200 uA direct current at 24 points of the body regarded as representative of systemic sympathetic activity. Results. There was no correlation between the clinical characteristics of a pain syndrome and GSR changes. Skin conductance values significantly more often fell within the normal range following exposure to a low frequency magnetic field compared of the other physical therapy methods investigated in the study. Conclusions. The following conclusions can be made on the basis of the observed outcomes: 1. The Ryodoraku method is non-specific and inappropriate as an additional tool for the diagnosis of sciatic neuralgia; 2. Some correlations can be established between conductance measurements and the physical treatment method used.
Key words:
low back pain, electrodermal measurements of Ryodoraku, physiotherapy
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Centralisation and peripheralisation of symptoms according to McKenzie Method among patients with chronic low back pain

Aleksandra Truszczyńska

Aleksandra Truszczyńska – Centralisation and peripheralisation of symptoms according to McKenzie Method among patients with chronic low back pain. Fizjoterapia Polska 2011; 11(4); 351-356

Abstract
Background. Diagnosis of lumbar sciatica is based on classical neurological examination and radiographic imaging. In literature, McKenzie described detailed functional tests concerning pain response during mechanical procedures. Centralisation of pain confirmed during examination informs the examiner that conservative treatment is indicated. Contrary to that peripheralisation of symptoms, it confirms that derangement is irreducible. The aim of the study was to show that the method of functional exa­mination enables diagnosis of centralisation or peripheralisation of pain among chronic patients with sciatica. The additional aim was to determine the factors identified from objective evaluation which determine further treatment of these patients. Material and methods. 200 patients with low back pain and sciatica were precisely analysed. There were 84 men (42%) and 116 women (58%), age between 13-79 years (43.0±13,65). Peripheralisation of pain was found in 65 patients (group A), and centralisation – in 135 persons (67.5%). Statistical analysis showed that significant differences between groups included: lateral shift, SLR test, sensory and motor deficits.Conclusions. 1. Precise analysis showed that among chronic patients with disc disease clinical tests lead to centralisation or peripheralisation of pain. 2. Peripheralisation was statistically more often accompanied with lateral shift, neurological deficits and low results of straight leg raise (SLR) test.
Key words:
chronic pain, Low Back Pain, McKenzie method
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Nerve root tests results for diagnosis and prognosis of the pain syndromes in the lumbar spine area treated under spa conditions

Przemysław Minta, Wiesław Tomaszewski, Monika Sobolak

Przemysław Minta, Wiesław Tomaszewski, Monika Sobolak – Nerve root tests results for diagnosis and prognosis of the pain syndromes in the lumbar spine area treated under spa conditions. Fizjoterapia Polska 2012; 12(1); 21-27

Abstract
Disorders associated with low back pain (lbp) are the result of not only affliction of nerve roots, but also nocireceptive innervated structures of the ligaments and joint capsules. The objective of this study was to determine the prevalence of selected nerve root tests in people selected by the Social Insurance Board (SIB) and the National Health Fund (NHF) for spa treatment due to lbp, and their usefulness for diagnosis and prognosis.The study involved a group of 400 people (200 people recommended by SIB and 200 by the NHF). In questionnaires, beside the basic personal characteristics, the following were taken into consideration: disease duration, pain location and radiation, results of imaging tests, employment status and type of work performed. The questionnaires also carried results of some nerve roots tests carried out. Positive nerve root tests occurred more frequently in people recommended by the SIB for prevention of disability pension award, and their frequency increased with duration of illness and PIT taxable allowance period. SIB patients were recommended for treatment as a result of a disease that was at a more advanced stage than patients from NHF. Analysis of obtained data showed that nerve root tests, in both groups were present in only a quarter of the tested patients, hence this points to their limited diagnostic and prognostic value.
Key words:
Low Back Pain, nerve root tests, spa treatment, prevention of disability pension award
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Strength and kinesthetic differentiation of deep muscles stabilizing lumbar spine in low back subclinical pain complaints

Mirosław Kokosz, Edward Saulicz, Tomasz Wolny, Mariola Saulicz, Andrzej Myśliwiec, Łukasz Gębala, Oliwia Mokrus, Paweł Linek

Mirosław Kokosz, Edward Saulicz, Tomasz Wolny, Mariola Saulicz, Andrzej Myśliwiec, Łukasz Gębala, Oliwia Mokrus, Paweł Linek – Strength and kinesthetic differentiation of deep muscles stabilizing lumbar spine in low back subclinical pain complaints. Part 1. Fizjoterapia Polska 2012; 12(2); 101-112

Abstract
Background. Lumbar spine pain is one of the most frequent malfunctioning of the locomotor system. The aim of this article was to examine whether there is a co-relationship between the preliminary, subclinical symptoms of pain and the strength and kinesthetic differentiation of deep muscles stabilizing the lumbar spine in the lower section of spine. Material and methods. Appearance of pain in lumbar spine was taken as an independent variable. The average intensity of the ailment was 8.81 points (±3.68) in the Oswestry scale in 52 subjects. The second group composed of 48 persons who, at the time of the examination, felt no pain in the low back. Both groups were matched regarding the basic parameters: age, body weigh, height, level of physical activities and sex. Results of tests carried out with the use of pressure stabilizer in the supine and prone positions constituted the dependent variables. Results. Statistical analysis showed that there are significant dependencies between the presence of pain and strength and kinesthetic differentiation in the prone position. No such dependencies were registered in the supine position. Conclusions. Weakness of the deep stabilizing muscles is characteristic for persons with perceived minor lumbar spine pain. The ability to differentiate pressure force is also disturbed. It seems that an examination performed in a prone position is useful in detecting the above changes.
Key words:
Low Back Pain, muscular stabilization, Proprioception
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Effect of 12-weeks adapted physical activity on back disability and pain in Brazilian elderly

Eleonora Esposito, Paola Sinibaldi Salimei, Chiara Salimei, Mohammad Al-Wardat

Eleonora Esposito, Paola Sinibaldi Salimei, Chiara Salimei, Mohammad Al-Wardat – Effect of 12-weeks adapted physical activity on back disability and pain in Brazilian elderly. Fizjoterapia Polska 2021; 21(1); 42-46

Abstract
Aim. Back pain (BP) is a common disabling health problem that affects negatively activity of daily living (ADLs) and quality of life (QoL). Physical activity (PA) showed exerts beneficial effects on BP symptoms and health status. This study aimed to investigate the effect of adapted physical activity (APA) on back disability and pain in Brazilian elderly.
Material and Methods. Forty-eighth elderly people with chronic non-specific BP participated in APA program twice a week for 12-weeks each session for 50 minutes. The function, disability and pain were assessed by Oswestry disability index (ODI) and Visual Analogue Scale (VAS). Additionally, bilateral hip extension range of motion (ROM) and lengthening capacity of bilateral hamstring muscles, and hip flexors were evaluated.
Results. The ODI and VAS scores showed significant improvement post APA interventions. Moreover, hip extension ROM, bilateral hip flexor and extensors muscles flexibility significantly improved as well.
Conclusions. Our findings demonstrate that the 12-weeks APA interventional program was associated with significant improvements in back disability and pain in elderly with chronic non-specific BP. APA interventions should be employed to provide improvement in pain and functional status in the treatment of BP. Further studies are needed to determine whether long-term of APA may improve QoL and ADLs for elderly with BP.
Key words:
low back pain, adaptive physical activity, back function, physiotherapy, rehabilitation
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Effect of interferential current augmented by strengthening exercises for core muscles on low back pain after delivery. A Randomized Controlled Trial

Mona Salah Nagieb Ali, Magda Sayed Moursy, Samira El-Malah

Mona Salah Nagieb Ali, Magda Sayed Moursy, Samira El-Malah – Effect of interferential current augmented by strengthening exercises for core muscles on low back pain after delivery. A Randomized Controlled Trial . Fizjoterapia Polska 2020; 20(5);  84-88

Abstract

Purpose. To determine the effect of interferential current augmented by strengthening exercises for core muscles on low back pain after delivery. Design. single blind randomized controlled trial. Methods. Thirty multiparous women suffering from postpartum low back pain (for at least 3 months after delivery) participated in the study, they were selected randomly from the outpatient clinic of obstetrics and gynecology in Police Authority Hospital at Naser City, Cairo, Egypt; their ages ranged from 25-40 years old, through a period of 33 months (from May 2017 to February 2020). Confidentiality was assured. They were assigned randomly into two groups equally in number; 15 patients each: Group (A) patients received interferential current on the lower back for 20 minutes, 3 times /week for 4 weeks, additionally to this, they were asked to perform strengthening exercises for back & abdominal muscles, posterior pelvic tilting and postural correction exercises for 60 minutes, 3 times / week for 4 weeks. Group (B) patients were asked to perform strengthening exercises for back& abdominal muscles, posterior pelvic tilting and postural correction exercises for 60 minutes, 3 times / week for 4 weeks. Results. Comparing both groups post-program revealed that there was a highly statistically significant reduction in present pain intensity scale and serum cortisol level (p < 0.05) in favor of the group (A). Conclusion. interferential current augmented by strengthening exercises for core muscles had a significant effect on low back pain after delivery, so this study supports the value of interferential current on low back pain after delivery patients.

Key words:
interferential current, strengthening exercises, core muscles, low back pain, present pain intensity scale, plasma cortisol level
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Effects of selected work-related factors on the prevalence of musculoskeletal disorders

Małgorzata Chochowska, Joanna Jutrzenka-Jesion, Dorota Hojan-Jezierska

M. Chochowska, J. Jutrzenka-Jesion, D. Hojan-Jezierska – Effects of selected work-related factors on the prevalence of musculoskeletal disorders. Fizjoterapia Polska 2020; 20(2); 42-51

Streszczenie

Objective. The evaluation of low level laser therapy (LLLT) and ultrasound (US) efficacy in treatment of chronic nonspecyfic low back pain (NLBP) and their impact on the reduction of the level of soft tissue tenderness to palpation and the improvement in spinal mobility.
Material and methods. 120 patients suffering from NLBP were included in the study (groups: I, II, III, 30 people in each one). All patients received 10 treatment sessions, including: 1) personalized kinesiotherapy (10 sessions x 30min); 2) self-therapy (twice a day x 30min); 3) patient education (10 sessions x 30min). Group I was a control group. Group II additionally received 10 applications of LLLT, and group III received 10 applications of US. Patients were examined twice: on the first day of therapy and after three weeks of treatment. Evaluation was done by means of examining lumbar spine mobility in all planes and evaluating soft tissue tenderness to palpation in 24 control points (CP), which were exposed to LLLT (group II)/US (group III) according to the Andrzejewski-Kassolik Scale (AKS).
Results. All groups participating in the study gained a statistically significant improvement (p < 0,05; Wilcoxon Test) with regards to decrease in the level of soft tissue tenderness to palpation according to the AKS, in 23 out of 24 control points (CP). In groups II and III a statistically significant improvement (p < 0,05; Wilcoxon Test) in lumbar spine mobility was gained (except L/R rotation). Moreover, following the end of therapy there was a significantly improvement in spinal mobility (p < 0,05; U-Mann-Whitney test) compared to the control group: in group II in 5 out of 8 tested ranges of movement and in group III in 3 out of 8 tested ranges of motion; and also between groups III and II in 2 out of 8 tested ranges of motion.
Conclusions. 1) The application of personalized kinesiotherapy and education in the area of pain prevention contributes to the improvement in the condition of those with chronic NLBP. 2) The additional application of LLLT and US decreases the level of soft tissue tenderness to palpation, as well as increases spinal mobility in people with chronic NLBP. 3) Slightly better results were obtained following the application of US, however it cannot be explicitly concluded either of these applications is the more effective approach.

Słowa kluczowe: low back pain, myofascial pain syndrome, lasertherapy, ultrasound, range of motion improvement

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Evaluation of the effectiveness of selected physical therapy programs in patients with 1st and 2nd degree spondylolisthesis on the basis of stabilographic tests and muscle torque in statistics

Justyna Rdzanek

J. Rdzanek – Evaluation of the effectiveness of selected physical therapy programs in patients with 1st and 2nd degree spondylolisthesis on the basis of stabilographic tests and muscle torque in statistics. Fizjoterapia Polska 2020; 20(2); 6-19

Abstract

Objective. The objective of the study was to assess the effectiveness of the proposed treatment programs for patients with 1st and 2nd degree spondylolisthesis.
Material and method. The study involved 40 patients aged 50-80 with radiologically diagnosed 1st and 2nd degree spondylolisthesis. The subjects were randomly divided into two groups: a group treated according to the standard program used in NFZ (National Health Fund) institutions and a group treated according to the proprietary rehabilitation program. In each of the patients, the intensity of pain was measured, and stabilographic measurements, torque measurements during flexion and extension of the torso under static conditions were carried out.
Results. Mann-Whitney U analysis showed significant differences for most variables measured between treatment groups (p < 0.05). According to the results of descriptive statistics, patients treated using the method of a routine rehabilitation program applied at an NFZ institution achieved significantly higher results in the measurement of the intensity of pain PO and during stabilographic tests, standing on both legs with both eyes closed PO [mm] than patients treated using myofascial trigger point therapy (p < 0.05). On the other hand, significantly higher results in stabilographic measurements with open eyes PO [mm] and when straightening the torso under static conditions (Nm) were achieved by a group of patients treated using myofascial trigger point therapy (p < 0.05).
Conclusions. The results of the study allowed for the evaluation of the effectiveness of the proposed treatment programs for patients with 1st and 2nd degree spondylolisthesis, and then to decide on the modification of routinely used treatment programs for this disease in NFZ institutions.

Key words: spondylolisthesis, spine work, low back pain, treatment

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Bol donjeg dijela kralježnice – sažetak Susreta stručnjaka u 2017. godini

Mateusz Wojciech Romanowski, Anna Kostiukow, Łukasz Kubaszewski, Wojciech Romanowski, Marian Majchrzycki, Ernest Wiśniewski, Włodzimierz Samborski

M. W. Romanowski, A. Kostiukow, Ł. Kubaszewski, W. Romanowski, M. Majchrzycki, E. Wiśniewski, W. Samborski – Low back pain – summary of the 2017 Expert Meeting. Fizjoterapia Polska 2019; 19(1); 108-122

Abstract
Low back pain (LBP) is one of the main causes of health problems in developed countries. LBP can lead to a high degree of disability and sometimes involve high costs of treatment. The causes of LBP can be classified into the basic three groups: non-specific pain, pain potentially related to radiculopathy or spinal stenosis, pain potentially related to another specific cause. Treatment of low back pain should be directed to the cause of the disorder, and mainly includes non-invasive treatment, physiotherapy, pharmacotherapy, education. Invasive treatment of LBP includes pharmacological blockade, surgery.

Key words:
lower back pain, low back pain, non-specific lower back pain

 

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