坐骨神经痛:与Maitland动员,McKenzie练习和NMES混合治疗-一个案例研究

M. Shah, Suraj Mathew
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摘要

坐骨神经痛是指涉及下肢任何部位的神经根病,由炎症或压迫L1-S1神经根引起。主要通过适当的病史记录和体格检查来诊断,以免与其他慢性腰痛疾病误诊。急性期为6-8周,建议行手术治疗时,首选保守治疗。尽管各种研究表明,长期保守治疗比短期手术(椎间盘切除术)更合适。坐骨神经症状的患病率从1.6%到43%不等,在工作人群中最高,这引起了人们对有效和早期保守治疗的关注,以减轻引起不适和疼痛的症状。因此,本病例报告的目的是提供早期有效的保守治疗,结合梅特兰运动、麦肯齐运动和神经肌肉电刺激(干扰电流),以最大限度地减少不适,从而缓解和支持个人的日常生活活动,然后简单地回到娱乐活动中。根据患者的耐受性,对患者进行连续7天的梅特兰运动、麦肯齐运动和干扰电流的混合管理,并进行量身定制的家庭运动计划。在干预期的7天前后分别采用数值疼痛评定量表、下肢功能量表和Roland Morris失能问卷来评估疼痛和疼痛相关失能的预后。因此,干预前和干预后结果的变化表明,在减轻疼痛和改善功能活动以及参与社会和娱乐活动方面取得了积极成果。
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Sciatica: Treatment with a Blend of Maitland Mobilization, McKenzie Exercises along with NMES - A Case Study
Sciatica is referred to radiculopathy involving any of the lower extremity, caused by either inflammation or compression of the nerve roots L1-S1. It can be diagnosed majorly through an appropriate history taking and physical examinations to not be misdiagnosed with other chronic low back pain conditions. A conservative management is preferred when in an acute stage of 6-8 weeks after which a surgical approached is advised. Although various studies have shown evidences that a prolonged conservative care is most fitting than a short term surgical approach (discectomy). The prevalence of sciatic symptoms ranging from 1.6% to 43%, maximum noted in the working population, has drawn attention for the need of an effective and early conservative care to downsize the symptoms causing discomfort and pain. Thus, the aim of the case report was to present with an early and effective conservative care with a blend of Maitland Mobilization, McKenzie exercises along with Neuro-Muscular Electrical Stimulation (Interferential Current) to minimize the discomfort thus easing and bolstering the individual in activities of daily living followed by an uncomplicated returning back to recreational activities. The patient was managed with a blend of Maitland Mobilization, McKenzie exercises and Interferential current for 7 days consecutively along with an individually tailored Home exercise program according the patient tolerance. Outcomes measures namely numerical pain rating scale, lower extremity functional scale and Roland Morris Disability Questionnaire were evaluated before and after the 7 day intervention period to assess prognosis in pain and pain related disability. Thus the changes in pre and post intervention results stated positive outcomes in reducing pain and improving the functional activity and participation in social and recreational ventures.
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