ABSTRACT
BACKGROUND: Lumbar percutaneous transforaminal endoscopic discectomy can decompress nerve root compression caused by herniated lumbar disc. Postoperative rehabilitation not only includes the recovery of surgical trauma, but also the recovery of lumbar muscle damage accompanied by lumbar disc herniation and the recovery of pelvic-leg function imbalance. OBJECTIVE: To evaluate the effectiveness and feasibility of staged rehabilitation program of lumbar motor chain based on McKenzie’s technique after lumbar percutaneous transforaminal endoscopic discectomy. METHODS: Totally sixty-two patients with lumbar disc herniation who were treated in the Beijing Bo’ai Hospital of China Rehabilitation Research Center from January 2012 to December 2018 underwent percutaneous transforaminal endoscopic discectomy. The patients were randomly divided into experimental group and control group, 31 cases in each group. The experimental group performed remote staged rehabilitation guidance based on McKenzie’s technology according to pre-set rehabilitation program for postoperative rehabilitation of lumbar motion chain: 2-6 weeks after operation as the first stage, 7-12 weeks as the second stage and 13-24 weeks as the third stage. Control group received regular postoperative rehabilitation. Visual analogue scale score, Japanese Orthopaedic Association score, Oswestry Disability Index, and SF-36 score were assessed in both groups pre-rehabilitation and 6, 12, and 24 weeks post-rehabilitation. Cross sectional area of the multifidus of the lumbar spine was detected under MRI 12 weeks post-rehabilitation. Gait analysis was conducted 24 weeks post-rehabilitation by using three-dimensional motion acquisition and analysis system. This study was approved by the Ethics Committee of Beijing Bo’ai Hospital of China Rehabilitation Research Center (approval No. 2019-011-1). RESULTS AND CONCLUSION: (1) After rehabilitation, visual analogue scale score, Japanese Orthopaedic Association score, Oswestry Disability Index, and SF-36 score were improved to different degrees in both groups compared with those before rehabilitation. Visual analogue scale score and Oswestry Disability Index were lower in the experimental group than those in the control group at 6 and 12 weeks (P 0.05). (3) Gait analysis exhibited that the ratio of left to right in the supporting phase of the experimental group was higher than that of the control group at 24 weeks (P < 0.05). (4) Results suggest that the staged rehabilitation program after percutaneous transforaminal endoscopic discectomy for lumbar disc herniation is in line with the characteristics of postoperative recovery of lumbar disc herniation, and has good effectiveness and feasibility.
ABSTRACT
Objective To observe the clinical effect of manipulation combined with McKenzie technique on discogenic low back pain. Methods 80 patients were randomly divided into control group (n=39, 1 case was lost) and observation group (n=40). The patients in obser-vation group received manipulation and McKenzie technique, while the control group received manipulation only. All the patients were eval-uated with Oswestry Disability Index (ODI), Visual Analogous Scale (VAS) and Self-rating Depression Scale (SDS) before and 3 weeks af-ter treatment. Results The scores of ODI, VAS and SDS decreased after treatment in both groups (P0.05). Conclusion Manipulation combined with McKenzie technique is more effective on discogenic low back pain.
ABSTRACT
Objective To compare the effect of the McKenzie method and traditional manipulation in the treatment of patient with cervical spondylotic radiculopathy. Methods Seventy-two patients (42 women and 30 men with an average age of 42.60?13.73 years ) were randomly divided into 2 groups: an observation group and a control group. Both groups were given cervical traction, medium frequency electrotherapy and ultrasound therapy. In addition, the observation group was also treated with the McKenzie techniques, while the control group was treated by traditional manipulation. All the subjects were evaluated in terms of the clinical effect, VAS(Visual analog scale), McKenzie′s movement loss. The 1-year follow-up results were obtained. Results Both groups got a good therapeutic effect( the cure rate was 69% and 55.5%, respectively) and significant pain relief (P0.05). Range of motion of the cervical spine of the observation group was significantly improved after the treatment(P