ABSTRACT
Spondylolisthesis is described as a translation of a vertebra with respect to the vertebra below without any modification or notable lesion to the pars interarticularis. Lumbar spondylolisthesis can be considered as various conditions like Kati shoola, Kati Graha, Trika Graha, Prushta Graha, Trika Shoola, Prushta Shoola, Grudrasi in Ayurveda. The present article deals with a case of diagnosed Grade 1 lumbar spondylolisthesis of L4 over L5 and got advised for surgery. The Ayurvedic diagnosis of Kati soola was made. Management included Abhyanga, Kativasti, Kshira vasti, Virechana, Vaitarana vasti and Chincha lavana sweda along with internal medications. Chincha lavana sweda is a very simple and effective Swedana procedure to cure pain in low back, especially due to Spondylolisthesis. But it is not widely used. This case report also wants to introduce the technique to Ayurvedic practitioners who are unaware of it. Before treatment, total score on Oswestry low back pain disability questionnaire was 34 (68%) and at the time of discharge, the score was 8 (16%). On Roland-Morris low back pain and disability questionnaire, the before treatment score was 17 and at the time of discharge it was reduced to 4. That means the patient showed an improvement of 76% on Roland-Morris low back pain and disability questionnaire. The present case report substantiates effectiveness of classical Ayurvedic Management in spondylolosthesis.
ABSTRACT
STUDY DESIGN: A prospective study in a hospital. PURPOSE: To investigate whether each disability based on the three sub-categories of the Roland-Morris disability questionnaire (RDQ) during hospitalization is associated with itself at 1 year postoperatively in patients with degenerative lumbar spinal stenosis (LSS). OVERVIEW OF LITERATURE: Although the total score of the RDQ represents whole pain-related disabilities or health-related quality of life, it is a shortcoming that multi-dimensional changes in disabilities are difficult to understand when only using the RDQ. METHODS: Fifty-seven patients with LSS (men, 28; women, 29; 63.0+/-12.1 years) were included. Disabilities, pain intensity and depressive feelings were assessed at preoperation, discharge and 1 year postoperatively. RESULTS: The range of "mental and physical activities (MPA)," "functional movements on/around a bed (FM)" and "walking function (WF)" scores were 0 to 13 (median, 8), 0 to 6 (median, 6) and 0 to 4 (median, 3) at preoperation; 0 to 12 (median, 0), 0 to 6 (median, 0), and 0 to 4 (median, 0) at discharge; and 0 to 8 (median, 0), 0 to 5 (median, 0), and 0 to 4 (median, 0) at 1 year postoperatively, respectively. The following significant multiple regression equations were obtained: MPA at 1 year postoperatively=0.56 (MPA at discharge)-0.10 (depression at discharge)+0.90 (adjusted r2=0.41), FM at 1 year postoperatively=0.35 (MPA at discharge)-0.06 (depression at discharge)+0.40 (adjusted r2=0.45) and WF at 1 year postoperatively=0.59 (WF at discharge)-0.08 (depression at discharge)+0.63 (adjusted r2=0.29). CONCLUSIONS: In our LSS population, each disability based on MPA and WF at discharge is associated with itself in the future. Therefore, disabilities excluding functional movements are longitudinally independent.
Subject(s)
Female , Humans , Activities of Daily Living , Hospitalization , Lumbar Vertebrae , Motor Activity , Prospective Studies , Quality of Life , Spinal Stenosis , Surveys and QuestionnairesABSTRACT
The aims of this study were; 1) to develop the final version of the Korean Roland-Morris Disability Questionnaire (RDQ), and 2) to compare the responsiveness between the RDQ and the Oswestry Disability Index (ODI) scores in patients having low back pain. The psychometric properties of the final Korean RDQ were evaluated in 221 patients. Among them, 30 patients were reliability tested. Validity was evaluated using an 11-point numerical rating scale (NRS) and the Korean ODI. The receiver operating characteristic (ROC) curve analysis of the RDQ and the ODI was compared in 54 patients with lumbar zygapophyseal (facet) joint pain. There was a moderate relationship between the RDQ and NRS (r = 0.59, P < 0.01) and a strongly positive correlation between the RDQ and the ODI (r = 0.76, P < 0.001). The Korean RDQ with the higher area under the ROC curve showed a better overall responsive performance than did the ODI in patients with lumbar facet joint pain after medial branch radiofrequency neurotomy (P < 0.01). The results of the study present the final version of the Korean RDQ is valid for assessing functional status in a Korean population with chronic low back pain.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Disability Evaluation , Disabled Persons , Low Back Pain/diagnosis , Pain Measurement , Psychometrics , Surveys and Questionnaires , Republic of Korea , Research Design , Severity of Illness IndexABSTRACT
[Objective]To compare the efficacies of three types of acupuncture modalities on the pain magnitude and disability of chronic low back pain (LBP).<BR>[Design]Single blind randomized controlled trial, three parallel arms.<BR>[Setting]Outpatients of the Meiji University of Integrative Medicine Hospital.<BR>[Subjects]Thirty-nine elderly patients (24 females, 15 males;age 71.2 ± 7.7) who suffered from LBP for at least six months.<BR>[Interventions]Subjects were randomly allocated to one of three groups. Tender point group (TeP, n = 13) received to the tender point. Trigger point acupuncture group (TrP, n = 13) received to the trigger points. Sham acupuncture group (SM, n = 13) mimicked needling without insertion of the needle in the trigger point. Acupuncture sessions were performed once a week for five weeks. <BR>[Main Outcome Measures]Pain intensity (visual analogue scale:VAS) and QOL (Roland-Morris Disability Questionnaire:RDQ). <BR>[Results]At the end of the treatment period, significant improvement was observed on pain intensity and QOL in the TrP group alone (p < 0.01). However, there were significant differences in pain at the three month follow-up.<BR>[Conclusion]These results suggest that trigger point acupuncture has a long-term effect on treatment for low back pain in aged patients.
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@#Objective To investigate the effect of bed rest on acute nonspecific low back pain(ANLBP).Methods87 cases were randomly divided into bed rest group (42 cases) and free activity group (45 cases).The bed rest group would be proper activity indoor and step up activity outdoor after absolute in bed for a week.The free activity group would be prescribed free activity.At the same time,all of them received physiotherapy and non-steroidal anti-inflammatory drugs (NSAIDs).The visual analogous scale (VAS) were measured before and 2 weeks after treatment.The Roland-Morris disability questionnaire (RMDQ) were measured before and 2,6 weeks after treatment.ResultsThe difference of VAS and RMDQ scores between these 2 groups were not significant before treatment (P>0.05),but were significant 2 weeks after treatment(P<0.05).Further more,the difference of RMDQ scores between these 2 groups were not significant 6 weeks after treatment (P>0.05).ConclusionThe bed rest about patients could not promote,but delay the improvement of the pain and disability in the early period or later period recovery of ANLBP.
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@#Objective To investigate the effect of bed rest on acute nonspecific low back pain(ANLBP).Methods87 cases were randomly divided into bed rest group (42 cases) and free activity group (45 cases).The bed rest group would be proper activity indoor and step up activity outdoor after absolute in bed for a week.The free activity group would be prescribed free activity.At the same time,all of them received physiotherapy and non-steroidal anti-inflammatory drugs (NSAIDs).The visual analogous scale (VAS) were measured before and 2 weeks after treatment.The Roland-Morris disability questionnaire (RMDQ) were measured before and 2,6 weeks after treatment.ResultsThe difference of VAS and RMDQ scores between these 2 groups were not significant before treatment (P>0.05),but were significant 2 weeks after treatment(P<0.05).Further more,the difference of RMDQ scores between these 2 groups were not significant 6 weeks after treatment (P>0.05).ConclusionThe bed rest about patients could not promote,but delay the improvement of the pain and disability in the early period or later period recovery of ANLBP.
ABSTRACT
[Objective] Although there is some evidence for the efficacy of trigger point acupuncture and tender point acupuncture treatments for chronic low back pain, differences between the therapeutic effect of trigger point needling and that of tender point needling remain unclear. We compared the therapeutic effects of trigger point acupuncture and tender point acupuncture treatment for chronic low pack pain in elderly patients.<BR>[Design] Single-blind clinical controlled trial, quasi-randomized, 2 parallel arms.<BR>[Methods] Nine patients, aged 65 or over, with chronic low back pain for at least 6 months were alternately allocated to the trigger point needling group (n=4) or tender point needling group (n=5). Patients received treatments once a week for five weeks. Outcome measures were pain intensity (Visual Analog Scale : VAS) and pain disability (Roland-Morris Disability Questionnaire : RDQ).<BR>[Results] After the treatment period, VAS and RDQ values had improved significantly in the trigger point group, but there were no significant improvements in the tender point group.<BR>[Conclusion] Differences in improvement between the trigger point and tender point groups seem to suggest that the trigger point needling was different from tender meridian point needling in respect to the therapeutic effect. Further studies are necessary to fully assess the efficacy of this treatment for chronic low back pain using a blinded or placebo control group.