运动控制与MULLIGAN动员对腰椎神经根病患者功能结局的影响(随机比较研究)

M. Alfa, Enas Elsayed, W. Shendy, M. El-Awady, Noura Elkafrawy
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摘要

摘要目的:探讨动力控制再训练与手部MULLIGAN SMWLM对腰椎神经根病患者功能结局的影响。方法:设计:随机比较研究。单位:开罗大学物理治疗门诊。参与者:60例慢性腰痛伴神经根病患者随机分为两组。干预:运动对照组30例,接受运动控制再训练加常规物理治疗。Mulligan组:30例患者采用Mulligan动员法加常规物理治疗,(3组/周,共8周)。结果测量:所有患者均采用倾斜仪(测量躯干活动范围)、Oswestry残疾指数(测量功能能力)、疼痛检测问卷(神经性疼痛)和视觉模拟量表(测量疼痛强度)进行检查。在基线和干预后测量所有结果。结果:干预后,两组患者的预后指标均有显著改善,其中动力对照组的改善更明显:Oswestry残疾指数(P < 0.001,从76.93±6.87提高到14.8±2.27)、疼痛检测问卷(P < 0.001,从34.26±1.98提高到12.66±2.16)、疼痛强度包括视觉模拟量表(P < 0.001,从7.53±0.52提高到2.06±0.7;屈曲(P < 0.001)从55.86±3.1到67.93±2.21,伸直(P < 0.001)从18.13±1.72到25.73±1.62,侧屈ROM从19.6±1.72到27.06±1.87。结论:与Mulligan活动法相比,运动控制再训练干预在改善腰椎神经根病患者的功能预后方面效果更好。关键词:腰痛,运动控制,mulligan概念。
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KINETIC CONTROL VERSUS MULLIGAN`S MOBILIZATION ON FUNCTIONAL OUTCOMES IN PATIENTS WITH LUMBAR RADICULOPATHY (Randomized Comparative study)
KINETIC CONTROL VERSUS MULLIGAN MOBILIZATION ON FUNCTIONAL OUTCOMES IN PATIENTS WITH LUMBAR RADICULOPATHY (Randomized Comparative Study) Abstract Objective: To investigate the effect of kinetic control retraining versus the hands on Mulligan SMWLM on functional outcomes in patients with lumbar radiculopathy. Methods: Design: Randomized Comparative Study. Setting: Outpatient, faculty of physical therapy clinic of Cairo university. Participants: Sixty subjects, suffered from chronic LBP with radiculopathy randomized equally into two groups. Intervention: The Kinetic control group, thirty subjects received kinetic control retraining plus convectional physical therapy. Mulligan group, Thirty subjects received Mulligan`s mobilization plus convectional physical therapy, (for 3setions/week, for 8weeks). Outcome measures: All patients were examined by inclinometer(for trunk range of motion), Oswestry disability index(for functional ability), pain detect questionnaire(neuropathic pain) and visual analogue scale(for pain intensity). All outcomes were measured initially at baseline and after intervention. Results: After the intervention, both groups showed significant improvement on the outcome measures with superior improvement of the kinetic control group for Oswestry Disability Index (P < 0.001, from 76.93 ± 6.87 to 14.8±2.27 and pain detect questionnaire (P < 0.001, from 34.26±1.98 to 12.66±2.16, pain intensity including visual analogue scale (P < 0.001, from 7.53±0.52 to 2.06±0.7, Lumbar ROM using Inclinometer: flexion (P < 0.001, from 55.86±3.1 to 67.93±2.21, extension (P < 0.001, from 18.13±1.72 to 25.73±1.62 and lateral flexion ROM from 19.6±1.72 to 27.06±1.87.Conclusion: Kinetic control retraining intervention gave superior effect on improving functional outcomes in patients with lumbar radiculopathy compared to Mulligan's mobilization. Keywords: Low back pain, kinetic control, mulligan concept.
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