Lumbosacral Radiculopathy
Conditions
Keywords
posterior oblique sling, recruitment pattern, lumbar radiculopathy
Brief summary
The current study aims to determine the impact of augmented posterior oblique sling activation on lumbopelvic recruitment pattern and functional outcomes in patients with unilateral lumbosacral radiculopathy.
Detailed description
Low back pain is now the leading cause of disability worldwide. Back pain and its related disability have a huge impact on individuals, communities, and healthcare systems. It reduces an individual's ability to participate in work which in turn negatively affects their quality of life. Also, it has major economic consequences through increasing the cost of health care and work absenteeism. Among the many differentials of low back pain, the most common cause is lumbosacral radiculopathy. Patients with low back pain showed uncontrolled lumbopelvic mobility while performing hip extension movement in functional activities. In patients with back pain, there is over-activation of the hamstrings and erector spinae and delayed or absent contraction of the gluteus maximus. Clinically, this pattern is observed as an anterior pelvic tilt with increased extension in the lumbar spine as the patient lifts the leg into extension. So, repetition of this abnormal pattern in patients with lumbosacral radiculopathy may result in mechanical and compressive stresses in the lumbar spine and magnify the patient's symptoms. Despite the role of POSM in improving spinal mobility and stability. And stabilizing the lumbopelvic joint, there are no previous studies investigating the impact of activation posterior oblique activation on this abnormal lumbopelvic recruitment and functional outcomes in patients with lumbosacral radiculopathy.
Interventions
OTHERaugmented posterior oblique sling activation
activation of posterior oblique sling program for 18 sessions, three sessions per week for six weeks in the form of: * drop and catch technique * modified prone hip extension exercises * trunk and leg dissociation task
OTHERselected physical therapy program
selected physical therapy program for 18 sessions, three sessions per week for six weeks in form of soft tissue techniques, mobilization and manipulation of lumbar spine, and neurodynamics and stabilization exercises
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Intervention model description
Randomized controlled trial. True experimental research design study
Eligibility
Sex/Gender
FEMALE
Age
30 Years to 46 Years
Healthy volunteers
No
Inclusion criteria
* Age ranges from 30 to 46 * L5/S1 disc herniation. * Duration of pain is more than three months. * body mass index less than 30 kg/cm2 * ability to perform prone hip extension task with no pain * impaired lumbopelvic stability (\<5 mmHg pressure difference from baseline to end prone hip extension task) * moderate to severe lumbosacral radicular pain
Exclusion criteria
* Red flags: spinal tumors, cauda equina syndrome, spinal fractures, osteoporosis, infection. * Bilateral symptoms. * Spondylolisthesis, spondylitis, and spinal canal stenosis. * Previous lumbopelvic or hip surgery or injection * Any hip structural abnormality such as malformations, impingements and degeneration. * Postural deviations such as scoliosis, kyphosis, lateral shift. * True leg length discrepancy. * Pregnancy and Gynecological problems.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| surface EMG unit | measurements will be done 3 days before the start of the treatment program and will be done after 3 days post intervention | The electromyographic pattern of activation of lumbopelvic musculature (sequence and level of activity) will be measured during prone hip extension testing using surface EMG unit. |
| Pressure biofeedback unit | measurements will be done 3 days before the start of the treatment program and will be done after 3 days post intervention | it will be used to assess pelvic motion. the pressure sensor of the pressure biofeedback unit will be placed anteriorly between the patients' ilium and the testing table. The amount of pressure applied by the patient on the sensor at rest will be recorded then, the amount of pressure applied by patients at prone hip extension at 10 degrees will be recorded. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| pressure algometry | measurements will be done 3 days before the start of the treatment program and will be done after 3 days post intervention | The pressure algometry will used to measure pressure pain threshold in low back area and in sciatic valleix. |
| Arabic version of Oswestry Low Back Pain Disability Questionnaire | measurements will be done 3 days before the start of the treatment program and will be done after 3 days post intervention | back pain-related disability will be assessed using using the Arabic version of Oswestry Low Back Pain Disability Questionnaire.It is a 10-item self-reported questionnaire. The patient will be asked to answer every question and mark only the box that most closely describes his problem. Each question will be assessed on a six-point scale ranging from 0 (no disability) to 5 (major disability). The score is determined by adding each item score together. The overall score is out of 50 . Higher scores represent greater disability. |
| back pain intensity using the Visual analogue scale | measurements will be done 3 days before the start of the treatment program and will be done after 3 days post intervention | The subject will be asked to make a handwritten mark on a 100 mm line (10cm). This line represents a continuum between no pain or discomfort (zero), and the worst pain (10) the patient could feel. Measurements from the starting point of the scale to the patients' marks will be recorded and interpreted as their pain intensity. Higher scores represent greater pain. |
Countries
Egypt
Contacts
STUDY_CHAIRHoda M Zakaria, professor
Cairo University
STUDY_CHAIREbtesam M Fahmy, professor
Cairo University
STUDY_CHAIRNagwa M Ibrahim
Cairo University
Outcome results
None listed