腰骶神经根病中神经动力学与神经动力学持续自然椎体滑动的影响

Anwesh Pradhan, Muthukumaran Jothilingam, Shabnam Agarwal
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引用次数: 0

摘要

腰骶神经根病是中年人中常见的健康问题,患病率约为2.2%至8%。神经动力动员(NM)和神经动力持续自然椎体滑动(N-SNAG)技术被证明对腰骶神经根病有效。但在之前的研究中,关于其治疗效果的争议普遍存在。N-SNAG也是一种相对较新的技术,临床上正在使用,但需要更多的文献来分析其有效性。因此,我们的目的是评估N-SNAG与NM和常规全身运动治疗腰骶神经根病在疼痛、活动能力、残疾、肌肉激活和健康相关生活质量(HRQL)方面的疗效。127名年龄在30至50岁之间的患者被随机分为3个不同的治疗组,其中第一组和第二组接受N-SNAG和NM并进行一般锻炼,第三组(对照组)仅接受一般锻炼。在基线和第1周、第2周、第7周和第18周结束时评估各组腰髋屈曲活动度、主动直腿抬高、腰痛、神经根性疼痛、股二头肌和腓肠肌肌肉激活、残疾和HRQL。Bonferroni t检验的双向重复测量方差分析显示,组内和组间腰椎和髋关节屈曲范围、腰痛、神经根病疼痛、活动SLR、残疾和HRQL均有显著改善(p<0.05)。三组股骨二头肌和腓肠肌的肌肉活动也显著改善(p < 0.05),但组间差异无统计学意义(p < 0.05)。该研究得出结论,在改善腰骶神经根病患者的疼痛、腰椎和髋关节屈曲范围、SLR、残疾、肌肉激活和HRQL方面,N-SNAG比annm和一般运动更有效。
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Effects of Neurodynamics Versus Neurodynamic Sustained Natural Apophyseal Glide in Lumbosacral Radiculopathy
Lumbosacral radiculopathy is a frequently reported health issue in middle-aged people, with a prevalence varying fromabout 2.2% to 8%. Neurodynamic mobilization (NM) and Neurodynamic sustained natural apophyseal glide (N-SNAG) techniqueswere proven effective for Lumbosacral radiculopathy. But controversies are prevalent regarding the effectiveness of their treatmentin previous studies. N-SNAG is also a comparatively new technique that is clinically being used around, but more literature is neededto analyze its effectiveness. Hence, we aimed to evaluate the efficacy of N-SNAG in comparison with NM and conventional generalexercises in treating lumbosacral radiculopathy on pain, mobility, disability, muscle activation, and health-related quality of life(HRQL). One hundred and twenty-seven patients aged between 30 and 50 years were randomly allocated into 3 different treatmentgroups, where the first and second groups received N-SNAG and NM with general exercises, and the third (control) group receivedgeneral exercises only. Range of motion of lumbar and hip flexion, active straight leg raising, low back pain, radiculopathy pain, muscleactivation of biceps femoris and gastrocnemius muscles, disability, and HRQL were evaluated at baseline, and the end of 1st week, 2ndweek, 7th week and 18th week for all the groups. Two-way repeated measure ANOVA with Bonferroni’s t-test revealed significant(p<0.05) improvement in the range of lumbar and hip flexion, LBP, radiculopathy pain, active SLR, disability, and HRQL in both withingroups and between groups. Muscle activation of biceps femoris and gastrocnemius also improved significantly (p<0.05) in all threegroups, but no significant (p>0.05) differences were seen between groups. The study concludes that N-SNAG is more efficient thanNM and general exercise in improving pain, lumbar and hip flexion range, SLR, disability, Muscle activation, and HRQL in Lumbosacralradiculopathy patients.
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