脊柱活动加腿部运动与McKenzie技术治疗腰椎间盘突出症的疗效比较

Mohammad N. Selim, Maha M. Mokhtar, M. Mohamed, A. A. Abonour, Sahar M. Abdelmutilibe, Mohamed M. M. Essa
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摘要

背景:腰椎间盘突出症(LDH)是骨科门诊就诊最常见的原因之一。LDH被认为是一生中60- 80%腰痛病例的根本原因。目的:本研究旨在评估不同的手法治疗技术(Mulligan 's spinal mobilewith leg movement vs . McKenzie手法)对腰椎间盘突出症患者的疗效。设计:本研究是一项随机对照试验,招募45名诊断为LDH的个体作为研究的参与者(平均年龄48.54±5.8岁)。参与者被随机分为三组,每组15人。干预措施:A组(实验A组)采用Mulligan脊柱活动法配合腿部运动和经皮神经电刺激(T.E.N.S.)。B组(实验组B组)采用McKenzie技术。C组(对照组)参与者只接受为期四周的T.E.N.S.。三组患者每周均接受3次治疗。疼痛、功能障碍和H反射是主要的结局指标。采用视觉模拟评分法(VAS)评估疼痛,采用Oswestry功能障碍评分法评估功能障碍,采用肌电法评估H反射。结果:与其他组相比,A组参与者的疼痛强度和严重程度均有显著改善,功能障碍水平降低,H反射改善。结论:与McKenzie技术和TENS技术相比,脊柱活动配合腿部运动能更有效地减轻腰椎间盘突出症患者的疼痛和功能障碍,并改善H反射。
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Comparison between efficacy of spinal mobilization with leg movement versus McKenzie technique in patients with lumbar disc herniation
Background: Lumbar disc herniation (LDH) is one of the most common causes of medical consultation in the orthopedic clinics. LDH is believed to be the root cause of 60-80 percent of low back pain cases over a lifetime. Objective: The current study aims to evaluate the effectiveness of different dissimilar manual therapy techniques (Mulligan’s spinal mobilization with leg movement versus McKenzie technique) in patients with lumbar disc herniation. Design: The present study is a randomized control trial in which 45 individuals diagnosed with LDH were recruited as the participants of the study (mean age 48.54 ± 5.8 years). The participants were randomly allocated into three groups, with n=15 in each group. Intervention: Participants of the group A  (Experimental group A) received  Mulligan spinal mobilization with leg movement and T.E.N.S. (Transcutaneous Electrical Nerve Stimulation). Group B (Experimental group B) participants received McKenzie technique. Group C (control group) participants only received T.E.N.S. for four weeks. All patients in the three groups received 3 sessions each week. Pain, functional disability, and the H reflex were the primary outcome measures. The visual analogue scale (VAS) was used to assess pain, the Oswestry disability scale was used to assess functional disability, and electromyography was used to assess the H reflex. Results: Significant improvements were seen in the participants of group A, with reduction in the intensity and severity of pain, decreased level of functional disability and improvement in the H reflex, in comparison with other groups. Conclusion: Spinal mobilization with leg movement was more effective than McKenzie technique and TENS to reduce pain and functional disability, and to improve the H reflex, in individuals suffering from lumbar disc herniation.
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