Tyrinėjant lėtinių nugaros skausmų kineziterapijos intervencijas: smūginės bangos terapijos vaidmuo

Maram Maki, Shima A. Mohammad Zadeh, Tamer M. Shousha

Maram Maki, Shima A. Mohammad Zadeh, Tamer M. Shousha – Exploring physiotherapy interventions for chronic back pain: the role of shockwave therapy – Fizjoterapia Polska 2024; 24(2); 178-182

DOI: https://doi.org/10.56984/8ZG5608NP7

Santrauka
Lėtinis nespecifinis apatinės nugaros dalies skausmas (LBP) kelia didelį pasaulinį sveikatos iššūkį, reikalaujantį daugiaplanės intervencijos efektyviam valdymui. Kineziterapija, su savo integruotu požiūriu, atlieka pagrindinį vaidmenį sprendžiant lėtinio LBP sudėtingumą, naudodama įvairias priemones, tokias kaip mankštos ir judėjimo terapija, manualinės terapijos bei švietimas kartu su gyvenimo būdo korekcijomis. Kognityvinė funkcinė terapija (CFT) išsiskyrė kaip perspektyvi, į pacientą orientuota intervencija, pabrėžianti individualizuoto požiūrio svarbą. Tačiau vis dar išlieka iššūkiai teikiant efektyvias, individualizuotas gydymo programas, dėl kurių gali atsirasti intervencijų perteklius arba nepakankamumas. Ekstrakorporinė smūginės bangos terapija (ESWT) pritraukė dėmesį kaip nauja terapinė intervencija lėtiniams nugaros skausmams gydyti, naudojant aukštos energijos smūgines bangas, kurios skatina gijimo procesus ir mažina skausmą. Nors ESWT rodo perspektyvumą gydant raumenų ir kaulų sistemos ligas ir įvairiuose tyrimuose indukuojant palankius efektus, jos specifinis taikymas lėtiniam apatinės nugaros dalies skausmui trūksta išsamių atsitiktinių klinikinių tyrimų, ypač kalbant apie radialinę ESWT. Dabartiniai įrodymai dažnai neatitinka aukščiausių įrodymais pagrįstos kineziterapijos standartų, o tai kelia iššūkių objektyviai vertinant plačiai praktikuojamų ESWT procedūrų klinikinį efektyvumą lėtiniam apatinės nugaros dalies skausmui gydyti. Apibendrinant, nors kineziterapija išlieka esminė valdant lėtinį nespecifinį apatinės nugaros dalies skausmą, įskaitant įvairias intervencijas, specifinis smūginės bangos terapijos vaidmuo ir efektyvumas, ypač lėtinių nugaros skausmų kontekste, reikalauja tolesnių išsamių tyrimų ir klinikinių tyrimų. Šioje apžvalgoje pabrėžiama, kad būtina atlikti išsamius tyrimus, siekiant nustatyti klinikinį smūginės bangos terapijos efektyvumą ir optimalų taikymą kineziterapijos protokoluose ilgalaikiam skausmo valdymui.

Raktiniai žodžiai
apatinės nugaros dalies skausmas, smūginės bangos terapija, kineziterapija

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Giliųjų audinių masažo ir tempimo derinio poveikis juosmens skausmo sužalojimų gijimui

Liza, Bafirman, Masrun, Mikkey Anggara Suganda, Rubiyatno, Didi Suryadi, Muhamad Sazeli Rifki, Danang Dwi Purwanto, Ramli, Youssouf Haïdara, Y. Touvan Juni Samodra, Baharuddin Hasan, Ilham Surya Fallo

 

Liza, Bafirman, Masrun, Mikkey Anggara Suganda, Rubiyatno, Didi Suryadi, Muhamad Sazeli Rifki, Danang Dwi Purwanto, Ramli, Youssouf Haïdara, Y. Touvan Juni Samodra, Baharuddin Hasan, Ilham Surya Fallo – Combination of deep tissue massage and stretching: Does it affect the healing of low back pain injuries? –  Fizjoterapia Polska 2024; 24(2); 70-76

DOI: https://doi.org/10.56984/8ZG5608CA7

Santrauka
Pagrindas ir tyrimo tikslas. Juosmens skausmas (LBP) yra nenormali būklė apatinėje nugaros dalyje, kurią lydi skausmo pojūtis, todėl patiriami judėjimo apribojimai. Todėl būtina speciali priežiūra, kad būtų sumažintas juosmens skausmas (LBP). Medžiaga ir metodai. Šis tyrimas yra priešeksperimentinis tyrimas, naudojant vienos grupės prieštesto ir po testavimo dizainą. Šiame tyrime pradinio testo duomenų (prieštesto) rezultatai buvo matuojami naudojant VAS, modifikuotą Schober testą, pirštų galų iki grindų testą (Fingertip to Floor) ir ODI, tada gydymui naudojant gilų audinių masažą ir tempimą. Terapija pacientams buvo teikiama 3 kartus per savaitę 3 savaites, po to atliekamas galutinis duomenų matavimas (po testavimo). Šio tyrimo dalyviai buvo pacientai LKP Rumah Sehat Mandiri klinikoje per pastaruosius 5 mėnesius, kurie patyrė juosmens skausmo sužalojimus. Šiame tyrime naudojamas tikslingas mėginių ėmimas, todėl buvo 20 žmonių, kurių amžius svyravo nuo 20 iki 60 metų. Šio tyrimo analizė naudoja SPSS Version 26 programą. Rezultatai. Rezultatai parodė, kad skausmo, lenkimo, tempimo, dešiniojo lenkimo, kairiojo lenkimo ir funkcijos indikatoriai turėjo reikšmingą poveikį naudojant giliųjų audinių masažo ir tempimo derinį, kurio reikšmė buvo 0.000 < 0.05. Kairiojo lenkimo indikatoriaus reikšmė buvo 0.001 < 0.05, todėl galima daryti išvadą, kad yra reikšmingas skirtumas giliųjų audinių masažo ir tempimo derinio gydyme. Išvados. Šio tyrimo rezultatai suteikia įrodymų, kad giliųjų audinių masažo ir tempimo derinys reikšmingai sumažina juosmens skausmo sužalojimų gijimą pacientams. Todėl giliųjų audinių masažo ir tempimo derinys gali būti taikomas gydant juosmens skausmo sužalojimus.

Raktažodžiai
juosmens skausmas, giliųjų audinių masažas, tempimas

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Impact of different types of anaesthesia for cesarean delivery on subacute low back pain intensity and disability: A retrospective cohort study

Mohamed G. Ali, Mohammed A. Soliman, Amel M. Yousef, Fahima M. Okeel, Mohammed A.M. Sarhan


Mohamed G. Ali, Mohammed A. Soliman, Amel M. Yousef, Fahima M. Okeel, Mohammed A.M. Sarhan – Impact of different types of anaesthesia for cesarean delivery on subacute low back pain intensity and disability: A retrospective cohort study. Fizjoterapia Polska 2022; 22(3); 116-121

Abstract
Background. Low back pain (LBP) is common after cesarean delivery. So, this study was conducted to assess and compare the intensity of subacute LBP and disability among women who underwent cesarean delivery with different anaesthetic types.
Methodology. This retrospective cohort study was conducted to 38 women “26 of them underwent cesarean delivery, assessed after 6 to 12 weeks from delivery, they were classified into: [epidural anaesthetic group (Group A) n = 6, spinal anaesthetic group (Group B) n = 13, general anaesthetic group (Group C) n = 7], they were either primiparous or multiparous who did not receive anaesthesia for at least one year prior to the last delivery, the other 12 women were the control group (Group D) who didn’t experience pregnancy or anaesthesia”.
Results. The mean values of visual analogue scale (VAS) in Group A, Group B, Group C, and Group D were 5.00 ± 1.67, 4.62 ± 1.12, 5.14 ± 1.21, and 2.17 ± 0.71, respectively. The ANOVA test revealed a significant difference in VAS (P = 0.0001; P < 0.05) among the four groups. while the post-hoc test revealed non-significant differences (P = 1.000; P > 0.05) between the three anaesthetic groups. Also, the mean values of Oswestry Disability Index (ODI) in the same four groups were 26.00 ± 16.68, 27.00 ± 11.72, 30.00 ± 6.87, and 25.00 ± 9.33, respectively. The ANOVA test revealed non-significant difference in ODI (P = 0.838; P < 0.05) among the four groups.
Conclusion. Epidural, spinal and general anaesthesia for cesarean delivery are associated with increased intensity of subacute LBP, but without significant differences between these anaesthetic types. However, they do not increase the disability.

Key words:
neuraxial anaesthesia, general anaesthesia, cesarean delivery, subacute period, low back pain

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Effect of visceral osteopathic manipulations on low back pain caused by visceral dysfunctions

ALshimaa Mokhtar Darwesh, Zahra Mohamed Hassan Serry, Shawky Abd El-Hamid Fouad, Heba Ahmed Ali Abdeen

ALshimaa Mokhtar Darwesh, Zahra Mohamed Hassan Serry, Shawky Abd El-Hamid Fouad, Heba Ahmed Ali Abdeen – Effect of visceral osteopathic manipulations on low back pain caused by visceral dysfunctions. Fizjoterapia Polska 2021; 21(5); 44-49

Abstract
Purpose. To assess the efficacy of visceral osteopathy for low back pain (LBP) caused by visceral dysfunctions.
Methods. Randomized controlled trial. This research included forty participants ranged in age from 25 to 40 years old who were suffering from LBP due to visceral dysfunctions. They were split into two classes of the same size; Study group (A) received visceral osteopathic manipulations once a_week for three weeks and Control group (B) received analgesic drugs only for three weeks. Visual analogue scale (VAS), Owestry disability index (ODI) and Modified Schober’s test (MST) were evaluated for all participants in both groups before and after treatment.
Results: The comparison between both groups revealed significant decrease in VAS and ODI (p < 0.05) as well as significant increase in MST (p < 0.05) in favor of study group (A) post treatment.
Conclusion: Osteopathy is effective in pain management and functional status improvements in LBP patients.
Key words:
osteopathy, low back pain, visceral dysfunction, visual analogue scale, Owestry disability index, Schober’s test
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Comparative evaluation of the analgesic effectiveness of selected physiotherapeutic methods in the treatment of low back pain syndrome

Jolanta Kujawa, Iwona Pyszczek, Jan Talar, Mirosław Janiszewski

Jolanta Kujawa, Iwona Pyszczek, Jan Talar, Mirosław Janiszewski – Comparative evaluation of the analgesic effectiveness of selected physiotherapeutic methods in the treatment of low back pain syndrome. Fizjoterapia Polska 2001; 1(3); 271-279

Abstract

Background. Low back pain, especially lumbosacral syndrome, is the most frequently encountered pain syndrome in musculoskeletal diseases. In many countries the question of low back pain has become a social problem. The basic task of rehabilitation teams is to make the proper choice of effective physiotherapeutic method. The goal of this study was to evaluate the analgesic effectiveness of selected combined physiotherapeutic methods in patients with low back pain. The results were analyzed for statistically significant differences correlating with the application of particular physical methods.Material and methods. 450 randomly selected patients (319 females, 131 males), age 21-79 (average age 56,53 years +/- 15,34) treated for low back pain syndrome in the Department of Medical Rehabilitation at the Łódź-Śródmieście Municipal Clinic were surveyed. Patients were divided into two groups: Group A received laser biostimulation, while Group B received interferential current instead of laser therapy. All patients studied went through a uniform, typical program of therapeutic exercises.The effectiveness of this combined therapy was evaluated on the basis of subjective pain reported on the modified Laitinen pain questionnaire, taking into account intensity, frequency, use of analgesics and motor activity. A clinical examination was also performed. Results. The investigation indicated that both selected combined physiothearapeutic methods have a measurable analgesic effect in the treatment in low back pain. However, laser therapy applied in combination with therapeutic exercises proved to have greater therapeutic efficiency for such patients compared to interferential current with therapeutic exercises, and this difference was statistically significant.

Key words:
low power laser therapy, Low Back Pain, physiotherapy
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Evaluating the manner of performing selected activities of daily living in the light of early prevention of low back pain

Aleksandra Rudzińska, Olga Nowotny-Czupryna, Henryk Knapik

Aleksandra Rudzińska, Olga Nowotny-Czupryna, Henryk Knapik – Evaluating the manner of performing selected activities of daily living in the light of early prevention of low back pain. Fizjoterapia Polska 2001; 1(4); 381-384

Abstract
Background. Low back pain is both a medical and a social problem. One way to limit its dimensions is prevention, broadly understood. In our research we attempted to determine how activities of daily living that are particularly burdensome for the spine are performed. Material and methods. Our research involved 265 healthy subject (i.e. without spinal pain symptoms at the moment of testing), among whom 136 were manual laborers and 129 were white-collar workers. The subject were asked to perform 3 movement tasks: to change body position from lying to standing, to assume a sitting position on a chair, and to lift a weigh from the floor. Results. The results we obtained indicate a lack of proper movement habits, which are essential in the prevention of low back pain in the great majority of subjects. Conclusions. It would be advisable to conduct training in the area of preventing strain on the spine, as a result of which spinal pain symptoms can develop. The general public should be made aware of the importance of the problem, with particular emphasis on the consequences of the errors committed on a daily basis.

Key words:
Low Back Pain, prevention, back school

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The treatment of herniated disks in the lumbo-sacral spine

M. Śniegocki, H. A. Kasprzak

M. Śniegocki, H. A. Kasprzak – The treatment of herniated disks in the lumbo-sacral spine. Fizjoterapia Polska 2002; 2(2); 128-133

Abstract
This article presents contemporary methods of surgical treatment for application in patients with herniated disk. In discussing the various methods the authors concentrate on indications and counterindications for their application. In view of possible complications, the necessity is stressed to perform precise neuroimaging diagnostics as a basis for making the decision whether or not to operate and further rehabilitation.

Key words:
lumbo-sacral discopathy, Low Back Pain, surgical treatment

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Biomechanical aspects of low back pain in equestrian riders

Ewa Hordyńska, Józef Opara

Ewa Hordyńska, Józef Opara – Biomechanical aspects of low back pain in equestrian riders. Fizjoterapia Polska 2002; 2(3); 235-240

Abstract
Back pain, from social standpoint, belongs to the most important illnesses, despite the fact that it does not pose a direct life threat. Eighty per cent of adults are estimated to suffer from back pain daily. Most frequently, though, the true reasons, for the illness remain unknown. However, revealing factors that influence the occurrence of back pain in riders, and especially dressage riders, may be of considerale preventive importance. The paper presents problems that arise im movement relation between the rider and the horse in view of biomechanics of the seat.

Key words:
Biomechanics, Low Back Pain, rider

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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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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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