Effectiveness of the rehabilitation program in patients with lumbar osteochondrosis and motor stereotype disorders using shock wave therapy

Authors

DOI:

https://doi.org/10.26641/2307-0404.2020.4.221408

Keywords:

lumbar osteochondrosis, myotonic reactions, motor patterns, shock wave therapy

Abstract

The study included 80 patients aged 22-44 (31.7±4.4) years with lumbar osteochondrosis with impaired motor stereotype and myotonic reaction of the lumbar-pelvic region muscles. The patients were randomized into two homogeneous groups depending on the physical rehabilitation program: in the main group a combination of shock wave therapy (SWT) with the Masterplus MP200 extracorporeal shock wave therapy device (5 procedures with a frequency of 11 Hz, an impact force of 3.8-4.0 bar,  intervals of 5-7 days) with a program of relaxing exercises according to the method of K. Levit was used; in the control group – only exercises program. The developed program of physical rehabilitation proved its effectiveness by a significant decrease in pain intensity indicators (p<0.001) by VAS scale, ODI disability level (p<0.001) and SKT kinesiophobia level (p <0.01), a significant increase in the spine mobility (p<0.05) and the lumbar spine mobility (p<0.05), flexion in the hip joints (p<0.05). The range of movements during extension, adduction and abduction of the hip joints also increased but not significantly. Normalization of the extensor muscle tone of the lumbar spine was observed in 87.5% of cases, the gluteus muscle tone – in 30.0%, and the piriformis muscle tone – in 27.5%. The frequency of registration of error patterns in the active combined movement of the lumbar segments and the pelvis decreased to 37.5% of cases as a whole. The developed program of physical rehabilitation proved to be effective compared with the results of the isolated application of relaxing exercises with a significant improvement by VAS scale (p<0.05), ODI (p<0.05) and SKT (p<0.05); normalization of the tone of the lumbar extensor muscles and the restoration of control of active movements in the lumbar-pelvic region are more often noted in more than a third of patients.

References

Levit K. [Manual medicine: Trans. from Ger­man]. Moscow: Medicine; 1991. Russian.

Ma Cong, Kolesnichenko VA. [Lumbar – pelvic rhythm in patients with lumbar osteochondrosis and degenerative lumbar spondylolisthesis at the surgical treatment stages]. Travma. 2014;15(1):100-7. Russian.

d'Agostino MC, Craig K, Tibalt E, Respizzi S. Shock wave as biological therapeutic tool: From mecha­nical stimulation to recovery and healing, through mechanotransduction. Int. J. Surg. 2015;24(Pt B):147-53. doi: https://doi.org/10.1016/j.ijsu.2015.11.030

Forster M, Mahn F, Gockel U, Brosz M, Freyn­hagen R, Tolle TR, Baron R: Axial low back pain: One painful area – many perceptions and mechanisms. PLoS One. 2013;8:e68273. doi: https://doi.org/10.1371/journal.pone.0068273

Black SB. From piriformis syndrome to deep gluteal syndrome. J. Pract. Neurol. 2018;9:82-85.

Comerford M, Mottram S. Kinetic control. The management of uncontrolled movement. Elsevier Aust­ralia, Churchill Livingstone. 2012;1:3-43.

Sadeghisani M, Sobhani V, Kouchaki E, Baya­ti A, Ashari A, Mousavi M. Comparison of lumbopelvic and hip movement patterns during passive hip external rotation in two groups of low back pain patients with and without rotational demand activitie. Ortop. Traumatol. Rehab. 2015;17(6):611-8. doi: https://doi.org/10.5604/15093492.1193032

Kim MH, Yi CH, Kwon OY, Cho SH, Cynn HS, Kim YH, Hwang SH, Choi BR, Hong JA, Jung DH. Com­parison of lumbopelvic rhythm and flexion-relaxation response between 2 different low back pain subtypes. Spine. 2013;38 (15):1260-7. doi: https://doi.org/10.1097/BRS.0b013e318291b502

Buckland AJ, Miyamoto R, Patel RD, Slover J, Razi AE. Differentiating hip pathology from lumbar spine pathology: key points of evaluation and management. J. Am. Acad. Orthop. Surg. 2017;25:e23-e34. doi: https://doi.org/10.5435/JAAOS-D-15-00740

Notarnicola A, Maccagnano G, Gallone MF, Mastromauro L, Rifino F, Pesce V, Covelli I, Moretti B. Extracorporeal shockwave therapy versus exercise pro­gram in patients with low back pain: short-term results of a randomised controlled trial. J. Biol. Regul. Homeost. Agents. 2018;32(2):385-89.

Haag TB, Fellinger E, Handel M, Beckmann C, Schneider C. Extracorporal shock wave induced mecha­nical transduction for the treatment of low back pain – a randomized controlled trial. Int. J. Engineer. Res. Scien. (IJOER). 2016:2(1);144-9.

Hodges PW, Moseley GL. Pain and motor control of the lumbopelvic region: effect and possible mecha­nisms. J. Electromyogr. Kinesiol. 2003;13:361-70. doi: https://doi.org/10.1016/S1050-6411(03)00042-7

Lee AY, Baek SO, Cho YW, Lim TH, Jones R, Ahn SH. Pelvic floor muscle contraction and abdominal hollowing during walking can selectively activate local trunk stabilizing muscles. J. Back. Musculoskelet. Re­habil. 2016;29(4):731-9. doi: https://doi.org/10.3233/BMR-160678

Masi AT, Nair K, Evans T, Ghandour Y, Clini­cal, biomechanical, and physiological translational interpre­tations of human resting myofascial tone or tension. Int. J. Ther. Massage Bodywork. 2010;3:16-28. doi: https://doi.org/10.3822/ijtmb.v3i4.104

Ovcharenko LM. Opportunities multifrequency focusing shock wave therapy in lecheni and intervertebral hernias of the lumbar spine. Int. Phys. Med. Rehab. J. 2018;3(5):448-52. doi: https://doi.org/10.15406/ipmrj.2018.03.00144

Perez Carro L, Fernandez Hernando M, Cere­zal L, Saenz Navarro I, Alfonso Fernandez A, Ortiz Castillo A. Deep gluteal space problems: piriformis syn­drome, ischiofemoral impingement and sciatic nerve release. Muscles, Ligaments, Tendons J. 2016;6(3):384-96. doi: https://doi.org/10.11138/mltj/2016.6.3.384

Sahrmann S, Azevedo DC, Van Dillena L: Diag­nosis and treatment of movement system impairment syndromes. Brazil. J. Phys. Therapy. 2017;21:391-9. doi: https://doi.org/10.1016/j.bjpt.2017.08.001

Sangyong L, Daehee L, Jungseo P. Effects of extra­corporeal shockwave therapy on patients with chronic low back pain and their dynamic balance ability. J. Phys. Ther. Sci. 2014;26:7-10. doi: https://doi.org/10.1589/jpts.26.7

Hyeonjee H, Daehee L, Sangyong L, CHunbae J, TaeHoon K. The effects of extracorporeal shock wave therapy on pain, disability, and depression of chronic low back pain patients. J. Phys. Ther. Sci. 2015;27:397-9. doi: https://doi.org/10.1589/jpts.27.397

Vassalou EE, Fotiadou A, Ziaka D, Natsiopoulos N, Karantanas AH. Piriformis muscle syndrome: MR imaging findings and treatment outcome in 23 patients. Hell. J. Radiol. 2017;2(4):38-44. doi: https://doi.org/10.1007/s00330-017-4982-x

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Published

2020-12-28

How to Cite

1.
Gresko I, Kolesnichenko V. Effectiveness of the rehabilitation program in patients with lumbar osteochondrosis and motor stereotype disorders using shock wave therapy. Med. perspekt. [Internet]. 2020Dec.28 [cited 2024Nov.23];25(4):127-3. Available from: https://journals.uran.ua/index.php/2307-0404/article/view/221408

Issue

Vol. 25 No. 4 (2020)

Section

CLINICAL MEDICINE

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