SPINAL FASCIA EXERCISE DECREASES THE PAIN AND IMPROVES QUALITY OF LIFE IN PATIENTS HAVE LUMBER DISC PROTRUSION

Main Article Content

Abdul Ghafoor Sajjad
Muhammad Shahid Javed
Mir Arif Hussain
Iqra Hamid
Muhammad Tanveer

Keywords

Disc Protrusion, Fascia Stretching Exercises, ELDOA

Abstract

Introduction: Low back pain is one of the most common causes of absenteeism in the workplace, school, or any other promising activity. Disc disease is one of the key contributors to low back pain and radiculopathy. One among many disc problems is disc protrusion, which has more prevalence in outpatient department physical therapy management Centre globally. One of the spinal fascia stretching exercise is Elongation Longitudinaux avec Decoaption Osteo-Articulaire (ELDOA).


Objective: To find out the effects of ELDOA exercises on pain and quality of life in patients with lumbar disc protrusion.


Material & Methods: The single-blind randomized control trial of 120 patients was conducted at Max Rehab & Physical Therapy Centre Islamabad, Pakistan. The inclusion criteria were lumbar radiculopathy due to lumbar disc protrusion. Patients were randomly allocated into groups through lottery method. Both groups received manual physical therapy treatment and ELDOA Group received additional ELODA exercises. The tools were Numeric Pain Rating Scale score of back pain, leg pain and patient functional level through modified Oswestry disability index. The data was collected before the 1st visit and after 8th visit.


Results: Both groups show significant difference, when we compared the group the Post NPRS (Back Pain), NPRS (leg pain) and MODI P value show there was a significant difference.


Conclusion: ELDOA exercises have improved the pain and quality of life in patients with disc protrusion.

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References

1. Hoy DG, Smith E, Cross M, Sanchez-Riera L, Blyth FM, Buchbinder R, et al. Reflecting on the global burden of musculoskeletal conditions: lessons learnt from the global burden of disease 2010 study and the next steps forward. Annals of the rheumatic diseases. 2015;74(1):4-7.
2. Hoy D, Raikoti T, Smith E, Tuzakana A, Gill T, Matikarai K, et al. Use of The Global Alliance for Musculoskeletal Health survey module for estimating the population prevalence of musculoskeletal pain: findings from the Solomon Islands. BMC musculoskeletal disorders. 2018;19(1):1-10.
3. Bogduk N. Functional anatomy of the disc and lumbar spine. The Artificial Disc: Springer; 2003. p. 19-32.
4. Jordan JL, Konstantinou K, O'Dowd J. Herniated lumbar disc. BMJ clinical evidence. 2011;2011.
5. Schwarzer AC, Aprill CN, Derby R, Fortin J, Kine G, Bogduk N. The prevalence and clinical features of internal disc disruption in patients with chronic low back pain. Spine. 1995;20(17):1878-83.
6. Inoue G, Ohtori S, Aoki Y, Ozawa T, Doya H, Saito T, et al. Exposure of the nucleus pulposus to the outside of the anulus fibrosus induces nerve injury and regeneration of the afferent fibers innervating the lumbar intervertebral discs in rats. Spine. 2006;31(13):1433-8.
7. Palmgren T, Grönblad M, Virri J, Kääpä E, Karaharju E. An immunohistochemical study of nerve structures in the anulus fibrosus of human normal lumbar intervertebral discs. Spine. 1999;24(20):2075.
8. Porchet F, Wietlisbach V, Burnand B, Daeppen K, Villemure J-G, Vader J-P. Relationship between severity of lumbar disc disease and disability scores in sciatica patients. Neurosurgery. 2002;50(6):1253-60.
9. Riley PM, Micheli LJ. Back pain in the young athlete. Injury in pediatric and adolescent sports: Springer; 2016. p. 135-47.
10. King AI. Injury to the Thoraco-Lumbar Spine. Accidental Injury: Biomechanics and Prevention. 2012:454.
11. Adams M, Hutton W. The mechanics of prolapsed intervertebral disc. International orthopaedics. 1983;6(4):249-53.
12. McNally D, Adams M, Goodship A. Can intervertebral disc prolapse be predicted by disc mechanics? Spine. 1993;18(11):1525-30.
13. Hansen L, De Zee M, Rasmussen J, Andersen TB, Wong C, Simonsen EB. Anatomy and biomechanics of the back muscles in the lumbar spine with reference to biomechanical modeling. Spine. 2006;31(17):1888-99.
14. Huang R, Meng Z, Cao Y, Yu J, Wang S, Luo C, et al., editors. Nonsurgical medical treatment in the management of pain due to lumbar disc prolapse: A network meta-analysis. Seminars in arthritis and rheumatism; 2019: Elsevier.
15. Ferreira PH, Ferreira ML, Maher CG, Herbert RD, Refshauge K. Specific stabilisation exercise for spinal and pelvic pain: a systematic review. Australian Journal of Physiotherapy. 2006;52(2):79-88.
16. Hammer WI. Functional soft-tissue examination and treatment by manual methods: Jones & Bartlett Learning; 2007.
17. Varun S MM, Jaspreet M, Naveen G. Comparison between posterior to anterior mobilization and traction SLR on pain and neurodynamic mobility in patients of low back pain. Int J Physiother Res. 2014;2(1):383-87.
18. Kuligowski T. Prevalence of Lumbar Segmental Instability in Young Individuals with the Different Types of Lumbar Disc Herniation—Preliminary Report. International journal of environmental research and public health. 2022;19(15):9378.
19. Tarcău E, Ianc D, Sirbu E, Ciobanu D, Boca IC, Marcu F. Effects of Complex Rehabilitation Program on Reducing Pain and Disability in Patients with Lumbar Disc Protrusion—Is Early Intervention the Best Recommendation? Journal of Personalized Medicine. 2022;12(5):741.
20. Khan GA, Khan A. Fascia Stretching Improve the Pain and Functional Level in Disc Protrusion Patients. Journal Riphah College of Rehabilitation Sciences. 2016;4(1):7-10.
21. Shamshad M, Kanwal R, Butt R, Haider HMM. Effects of ELDOA technique versus McKenzie extension exercises on non-specific low back pain patients.: a randomized clinical trial. The Rehabilitation Journal. 2022;6(03):429-34.
22. Arif R, Azfar H, Waseem A, Nawaz S, Sajjad AG. Effects of modified ELDOA technique in patients with cervical radiculopathy: ELDOA technique in patients with cervical radiculopathy. Pakistan BioMedical Journal. 2022:144-9.
23. Shahzad M, Rafique N, Shakil-ur-Rehman S, Ali Hussain S. Effects of ELDOA and post-facilitation stretching technique on pain and functional performance in patients with piriformis syndrome: A randomized controlled trial. Journal of Back and Musculoskeletal Rehabilitation. 2020(Preprint):1-6.
24. Dohnert B, Schwanck Borges C, Evaldt AS, de Jesus Francisco C, da Silva Dias L, Chuaste Flores B, et al. Lumbopelvic Stabilization Exercises and McKenzie Method in Low Back Pain Due to Disc Protrusion: A Blind Randomized Clinical Trial. Muscles, Ligaments & Tendons Journal (MLTJ). 2020;10(4).