Comparison of Selected Methods for Strengthening Stabilization Muscles of Lumbar Spine in Vertebrogenic Patients
Authors:
M. Holinka 1,2
; J. Gallo 2; I. Tozzi 3; M. Zvonař 4; M. Filip 5; J. Kristiníková 5; R. Pavličný 1
Authors place of work:
Ortopedické oddělení, Karvinská hornická nemocnice, a. s., Karviná
primář MUDr. R. Pavličný
1; Ortopedická klinika, LF UP, Fakultní nemocnice Olomouc
přednosta prof. MUDr. J. Gallo, Ph. D.
2; Klinika tělovýchovného lékařství a kardiovaskulární rehabilitace, LF UP, Fakultní nemocnice Olomouc
přednostka prof. MUDr. E. Sovová, Ph. D., MBA
3; Katedra kineziologie, Fakulta sportovních studií, Masarykova univerzita v Brně
vedoucí doc. Mgr. M. Zvonař, Ph. D.
4; Ústav rehabilitace, Lékařská fakulta, Ostravská univerzita
vedoucí doc. MUDr. M. Filip, Ph. D.
5
Published in the journal:
Rehabil. fyz. Lék., 24, 2017, No. 2, pp. 84-98.
Category:
Original Papers
Summary
Introduction:
Backache belongs to most frequent symptoms, which most of adult population encounter during life. Positive influence of strengthening stabilization muscles of spine on subsiding backache and improvement of common daily activities has been demonstrated in various studies. It has been abundantly used in sending patients to outpatient rehabilitation. On the other hand most patients are not sufficiently motivated for independent exercise after the outpatient rehabilitation ended. It resulted in frequent and ineffective repetition of rehabilitation several times a year. This work was intended to compare selected methods for strengthening stabilization of spine muscles in patients with chronic backache, which can be used in the home environment, to evaluate the real impact on the growth of muscular tissue by means of sonography examination, for improvement of daily activities, a decline of pains and to compare the results with outpatient rehabilitation and with each other. At the same time the authors intended to evaluate collaboration from the patient’s side and to evaluate the duration of tolerance and application of selected methods in individual groups of patients.
Methodic approach:
80 patients with chronic lumbar backache were included in the study, 29 men (36.3%) and 51 women (63.7 %) at the age of 31 to 83 years. The cohort encompassed two groups: patients treated by locomotor intervention (n=60) formed the first group, where the therapy of backache was made by strengthening of spine stabilization muscles (outpatient rehabilitation, gymnastic ball, dynamic directional pad). The control group was not subjected to aimed motion therapy (n=20) and was composed of patients, where the treatment was based on medication therapy. The pain intensity and limitation of daily activities were evaluated on the basis of visual analog scale and Oswestry questionnaire.
The strengthening of selected stabilization muscles of lumbar spine was evaluated by sonography examination. The study included observation of average analgesic consumption and duration of intervention with individual methods.
Results:
in this cohort of patients we recorded various degrees of declined backache, neurological symptomatology, analgesic consumption and improvement of common daily activities related to strengthening of stabilization muscles after 6 months of observation. However, with a decline of regular exercise after completed outpatient rehabilitation or diminished motivation for exercise on the gymnastic ball the original complaints reappeared as shown in the next control examination after 2 months of observation. It was accompanied by weakening of the already strengthened muscles to the original values. It became particularly manifest in m. multifidus. On the contrary the group of patients who strengthened the stabilization muscles of the spine by the dynamic directional pad revealed the longest period of intervention of the selected method. In agreement with this conclusion the authors recorded the highest increment of the extent of stabilization muscles together with decreased accompanying complaints in follow up examinations after 6 and 12 months. There was no marked change in the observed parameters in the control group.
Conclusion:
The observation that patients are very little willing to do exercise actively and independently in sufficient frequency or to continue the mastered exercise having completed outpatient rehabilitation may explain the frequent need of repetition. This long-term lack of collaboration from the side of some patients probably decreases its efficiency. In the long run this observation may explain increasing cost related to misuse of this kind of health care and the high consumption of analgesic preparations at the same time. The combined outpatient rehabilitation with long-term tolerated methods for strengthening of stabilization muscles of the spine in home conditions has proved useful as a possible solution in increased efficiency of this kind of care. Based on our results we may recommend the use of dynamic directional pad in routine practice.
Keywords:
stabilization muscles of the spine, sonography, muscular thickness, outpatient rehabilitation, gymnastic ball, dynamic directional pad, strengthening the stabilization muscles of the spine, health care cost
Zdroje
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Štítky
Physiotherapist, university degree Rehabilitation Sports medicineČlánok vyšiel v časopise
Rehabilitation and Physical Medicine
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