Annual ECSS-Congress, Bruges 2012
||[MO-PM48] Rehabilitation: Physiotherapy
Date & time:
||07.07.2016 / -
|Title of the paper:
EFFECTS OF THERAPEUTIC EXERCISE ON CLINICAL EVALUATION AND MAGNETIC RESONANCE IMAGING IN A PATIENT WITH MULTILEVEL DISC HERNIATION: A CASE REPORT
||Kim, A.R., Lee, H.S.
||Kinesiologic Medical Science
Lumbar disc herniation (LDH) is a common health problem that mainly occurs in younger adults, and leads to degenerative lumbar spinal disease in older adults (Jonsson and Stromqvist, 1995). LDH most typically manifests as low back and radicular leg pain, muscle spasm and nerve functional deficits, and causes both physical and social functional impairment (Ye et al., 2015). Although several exercise programs to improve functioning and pain in patients with lumbar disc herniation have been suggested (Gencay-Can et al., 2010), it is still controversial whether therapeutic exercise plays a major role in improving multilevel LDH. This study tested the hypothesis that therapeutic exercise would be improve clinical evaluation (pain, disability, physical function) and herniated lumbar discs by using magnetic resonance imaging (MRI) in a patient with multilevel disc herniation.
A-43-year-old female presented with low back pain, radicular pain in the right lower extremity and multilevel LDH (L3-L4, L4-L5, L5-S1). The therapeutic exercise program consisted of lumbar joint mobilization, lumbar spine flexion-distraction, abdominal bridge, plank, side plank and single-leg extensions from 4-point kneeling position for 40 minutes, three times a week, for 12-week. Clinical evaluation (low back and radicular pain, lumbar disability, lumbar range of motion; ROM, lumbar isometric strength and endurance, functional movement screen; FMS) was measured pre, after 6-week (post) and 12-week (post 1), and MRI examination was carried out pre and post 1 of therapeutic exercise.
Low back and radicular pain, and lumbar disability decreased at post and post 1 compared to at pre. Lumbar ROM increased at flexion, extension and lateral flexion of both sides. Lumbar isometric strength and endurance, and FMS improved at post and post 1 compared to at pre. The sizes of the herniated mass were reductions on MRI after post 1 compared to at pre.
Dzierżanowski et al. (2013) reported that exercise can reduce pain and improve functional abilities by improving the range of movement, muscle strength and body posture in single-level LDH patients. In this study, we demonstrated that therapeutic exercise decrease low back and radicular pain, improve functional capacity and sizes of the herniated mass by increasing range of motion of the spine and muscle strength in a multilevel LDH patient. These findings have clinical implications for therapeutic exercise in a patient with multilevel disc herniation.
Jonsson B, Stromqvist B. (1995). Eur Spine J. 4, 202–205.
Ye C, Ren J, Zhang J, Wang C, Liu Z, Li F, Sun T. (2015). Int J Clin Exp Med. 8(6), 9869-9875.
Gencay-Can A, Gunendi Z, Suleyman Can S, Sepici V, Çeviker N. (2010). Eur J Phys Rehabil Med. 46(4), 489-96.
Dzierżanowski M, Dzierżanowski M, Maćkowiak P, Słomko W, Radzimińska A, Kaźmierczak U, Strojek K, Srokowski G, Zukow W. (2013). Adv Clin Exp Med. 22, 421–30.
||Rehabilitation and Physiotherapy
||multilevel disc herniation
||magnetic resonance imaging