None listed
Conditions
Brief summary
this study was conducted to investigate the effects of forward head posture correction on three dimensional spinal posture parameters, back and leg pain, disability, S1 nerve root function of patients with chronic discogenic lumbosacral radiculopathy. Design: A randomized controlled trial with 2-year follow-up. Setting: University research laboratory. Subjects: 154 (54 female) patients between 40 and 55 years experiencing chronic discogenic lumbosacral radiculopathy with definite forward head posture were randomly assigned to either the control or experimental group. Interventions: Both groups received functional restoration programme, additionally, the experimental group received forward head posture corrective exercises. Main outcome measures: The anterior head translation, lumbar lordosis, thoracic kyphosis, trunk inclination, lateral deviation, trunk imbalance, surface rotation, pelvic inclination, leg and back pain scores, Oswestry Disability Index, and H reflex latency and amplitude were measured for all patients at three intervals. Results: The general linear model with repeated measures indicated a significant group × time effects in favor of experimental group on measures of anterior head translation (F=23.6 P<.0005), Oswestry Disability Index (F=89.7 P<.0005), H reflex amplitude (F=151.4 P<.0005), H reflex latency (F=99.2 P<.0005), back pain (F=140.8 P<.0005), and leg pain (F=72 P<.0005). There was no statistically significant effect for the remaining outcome measures; Surface rotation (F=1.2 P=.27), lumbar lordosis (F=0.4 P=.5), thoracic kyphosis (F=.04 P=.8), trunk inclination (F= .13 P=.72), and trunk imbalance (F=3.1 P=.06). Conclusion: The forward head posture correction is beneficial in treating the patients with chronic discogenic lumbosacral radiculopathy.
Interventions
The patients in both groups completed a 10-week functional restoration programme supervised by a physical therapist. Exercises then were continued more independently for a 2-year period at a public gymnasium. The exercise component of the patient’s programme consisted of 3 main phases. In phase 1, the patient attended 2 sessions per week for 4 weeks, during this phase the patient first was educated regarding his injury. The patient was taught self-management strategies aimed at minimizing therap
The patients in both groups completed a 10-week functional restoration programme supervised by a physical therapist. Exercises then were continued more independently for a 2-year period at a public gymnasium. The exercise component of the patient’s programme consisted of 3 main phases. In phase 1, the patient attended 2 sessions per week for 4 weeks, during this phase the patient first was educated regarding his injury. The patient was taught self-management strategies aimed at minimizing therapist dependence and empowering the patient to gain control over symptoms. In addition to implementing educational, self-management strategies, retraining of the transversus abdominis, lumbar multifidus, and pelvic-floor muscles started during this phase. The next stage of rehabilitation consisted of integrating the stabilizing pattern into a clinic-based, supervised functional restoration programme. In this stage, the patient attended the clinic 3 times per week for a 6-week period, and completed 2 additional exercise sessions each week at home. In the phase1 and 2, the sessions are administered on group basis. A maximum of five patients were included in the group, the number being limited by space . Each session lasted for 90 minutes. Following phase 2 of the functional restoration programme, the patient then commenced phase 3 of management, consisting of a relatively independent exercise programme at a public gymnasium in the form of endurance and low impact aerobic exercise. At this phase, all the patients are trained with a twice-per-week frequency .The sessions are administered on individual basis, each session lasted for 20 to30 minutes. Throughout all phases of the exercise programme, cognitive-behavioral strategies were used by the physical therapist, cognitive strategies included challenging counterproductive beliefs such as unrealistic expectations regarding recovery time frames and emphasizing the relative benefits of active exercise and self-management as opposed to passive treatment. Behavior modification included positive reinforcement of wellness behaviors such as increasing exercise intensity. Certain social behaviors such as returning to social activity and performing domestic tasks also were positively reinforced. A detailed functional restoration programme has been published previously . Those in the control group received this functional restoration programme only. The experimental group additionally received a posture corrective exercise programme in the form of two strengthening (deep cervical flexors and shoulder retractors) and two stretching (cervical extensors and pectoral muscles) exercises. The exercise programme was done according to Harman et al.’s protocol and based on Kendall et al.’s approach. The forward head posture corrective exercise programme commences concurrently with the start of Phase one of functional restoration programme , lasted for 30 minutes, and is strictly on a one-on-one basis only. A detailed posture corrective exercise programme has been published previously. This exercise programme was to be repeated four times per week for 10 weeks.
Sponsors
Ibrahim Moustafa Moustafa
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
44 Years to 55 Years
Healthy volunteers
No
Inclusion criteria
the patients were included if they had a confirmed chronic unilateral lumbosacral radiculopathy associated with L5-S1 lumbar disc prolapse with symptoms lasting longer than 3 months to avoid the acute stage of inflammation.Further, All patients had side-to-side H reflex latency differences of more than 1msec. Patients were also selected with lumbar hyperlordosis, which is considered a common posture aberrations in chronic low back pain patients
Exclusion criteria
Exclusion criteria included previous history of lumbosacral surgery, metabolic system disorder, cancer, cardiac problems, peripheral neuropathy, history of upper motor neuron lesion, spinal canal stenosis, rheumatoid arthritis, osteoporosis and any lower extremity deformity that might interfere with global postural alignment.
Outcome results
None listed