Effect of stretching of piriformis and iliopsoas in coccydynia.

Pain in the coccyx is referred as coccydynia. The pain aggravates in weight bearing i.e. sitting. Total 48 persons with coccydynia diagnosed clinically were recruited and randomly assigned into one of the 3 groups. Experimental group I were treated by stretching of piriformis and iliopsoas muscles, experimental group II were treated by stretching of piriformis and iliopsoas muscles and Maitland's rhythmic oscillatory thoracic mobilization over the hypomobile segments and the conventional group were treated by seat cushioning + Sitz bath + Phonophorosis. All participants underwent an initial baseline assessment for Pressure Pain Threshold (PPT) by using modified syringe algometer and pain free sitting duration. All the subjects were advised to minimise sitting posture and use a seat cushion. Treatment was given for 3 weeks, 5 sessions per week and post-treatment evaluation was done after completion of 3 weeks. Follow up evaluation was done after 1 month. DATA ANALYSIS: The data was analyzed by using 3 × 3 ANOVA. Tukey's HSD post-Hoc analysis was used for all pair wise comparison. RESULTS: The overall results of the study showed that there was significant improvement in pain pressure threshold and pain free sitting in both the experimental groups with treatment and improvement continued after cessation of therapy, whereas the conventional group did not improve significantly.

Mobilisation of the thoracic spine in the management of spondylolisthesis.

INTRODUCTION: Segmental instability due to lumbar spondylolisthesis is a potential cause of chronic low back pain. Hypomobility of the spine results in compensatory segmental hypermobility of the segment above or below restricted segments. Therefore, the aim of the study is to determine the effects of mobilisation of the hypomobile upper thoracic spine along with conventional flexion exercises and stretching of short hip flexors on the degree of slippage and the functions of the persons with lumbar spondylolisthesis. METHODOLOGY: All patients with spondylolisthesis were randomly assigned into two groups: Group I - Experimental group, treated with mobilisation of the thoracic spine along with the conventional physiotherapy and Group II - Conventional group, treated with conventional stretching, strengthening, and lumbar flexion exercise programme. RESULTS: The experimental group treated with mobilisation of the thoracic spine shows a significant reduction in the percentage of vertebral slip from pre-treatment to post-treatment measurements. CONCLUSION: Low back pain due to spondylolisthesis may be benefited by mobilisation of the thoracic spine along with stretching of short hip flexors, piriformis, lumbar flexion range of motion exercises, core strengthening exercises, etc.

Effect of thoracic mobilization on respiratory parameters in chronic non-specific low back pain: A randomized controlled trial.

BACKGROUND: Altered respiratory function has been found to be associated with back pain. Limited chest excursion in subjects with chronic low back pain (CLBP) may be due to co-contraction or bracing of erector spinae and abdominal muscles; their flexed spinal posture; and/or their compromised spinal stability resulting from dysfunctional transversus abdominis. OBJECTIVE: To check for the effects of thoracic mobilization on respiratory parameters in subjects with chronic non-specific low back pain. METHODS: Sixty-two subjects (excluding 11 dropouts) with CLBP of age group 30-60 were randomly allocated to two groups. Both groups received individualized treatment for low back pain (LBP) and HEP (home exercise program) regime of breathing exercises. In addition, group 1 received Maitland's Central postero-anterior vertebral pressure for thoracic spine (T1-T8). Total treatment duration was 10 sessions in 2 weeks (5 sessions/week). RESULTS: Results showed significant improvement in respiratory parameters viz. Forced Vital Capacity (FVC), Sustained Maximal Inspiratory Pressure (SMIP) and Chest Wall Expansion (CWE) and Oswestry Disability Index (ODI) in both groups (p< 0.05) at end of 2 weeks of intervention. However, improvement was significantly more in group 1 (p < 0.05) receiving additional thoracic mobilization. CONCLUSION: Subjects with non-specific chronic low back pain with or without radiation to lower limbs when treated with thoracic central PA mobilization, in addition to LBP specific treatment and breathing exercises, show an improvement in respiratory parameters and reduction in disability.

Effects of unilateral posteroanterior mobilization in subjects with sacralized lumbosacral transitional vertebrae.

AIM OF THE STUDY: To find out the efficacy of unilateral posteroanterior (PA) mobilization over type IA and type IIA sacralized lumbosacral transitional vertebrae in patients with low back pain with or without leg pain. RESEARCH DESIGN: experimental randomized control study. SAMPLE SIZE: 30 subjects, SAMPLING: simple random sampling. GROUP A - 15 subjects - self lumbar mobility and stretching exercises + Unilateral PA mobilization + hot pack. GROUP B - 15 subjects - self lumbar mobility and stretching exercises + hot pack. Before initiating treatment, subjects were assessed for dependent variables: Pain intensity by VAS, Forward bending and side bending ROM by modified finger to floor method with the help of an inch-tape and functions by Modified Oswestry Functional Disability Questionnaires. Post test measurements were taken after completion 2 weeks of therapy. The results of the study suggest that unilateral PA pressure is an effective mobilization method in reducing low back pain, improving ROM and related disability as compared to impairment based exercises alone in patients with low back pain with or without radiation to lower limbs having abnormally large transverse processes and hypomobile type IA and IIA lumbo-sacral transitional vertebrae.