Spondylolisthesis
Conditions
Keywords
hip extension mobilization, Spondylolisthesis, functional disability
Brief summary
this study will be conducted to investigate the effect of hip extension mobilization on lumber disability, pain and flexion range of motion in patients with spondylolisthesis
Detailed description
Spondylolisthesis is a kind of low back pain (LBP) that involves displacement of one vertebral body relative to the vertebra below it. Spondylolisthesis is derived from the Greek words spondylosis, which means vertebra, and olisthisis, which means slippage. The displacement of the cranial vertebra can be anterior (also known as anterolisthesis), lateral, or posterior (retrolisthesis) to the more caudal vertebra., most commonly occurring as an anterior slippage at the lumbosacral junction(L5-S1). The condition can result from several etiologies including congenital, isthmic, degenerative, traumatic, or pathologic causes. The clinical presentation of spondylolisthesis encompasses a broad spectrum, ranging from asymptomatic cases to those involving debilitating pain, neural compromise, and functional limitations. Degenerative spondylolisthesis (DS) predominantly affects older adults, with a marked predilection for females. A cross-sectional epidemiological survey involving over 4,000 patients reported a prevalence of 2.7% in men and 8.4% in women, underscoring a significant sex disparity.The most common site for degenerative spondylolisthesis is the L5 to S1 level. Mobilization increases hip range of motion, decreases pain and improves hip function more than non-weight bearing exercises.
Interventions
OTHERhip extension mobilization
the patients will receive hip extension mobilization to increase hip extension range of motion; the therapist applies an anterior glide mobilization-usually with the patient in a prone position. The patient is positioned in prone at the edge of the table. The hip is then flexed, abducted, and externally rotated into position as tolerated by the patient, and the foot is placed next to the contralateral knee. Impart anterior mobilization through the greater trochanter. The therapist applies a grade IV mobilization in a posterior to anterior direction to target the anterior hip. The mobilizing hand applies a downward ward force through an extended elbow; body weight exerts the force+ cinentional treatment
OTHERconventional treatment
Each subject will be given treatment of 30-40 minute session of William flexion exercises. The seven variations of Williams's exercises include (Pelvic tilt, single knee to chest, double knee to chest, half sit-up, hamstring stretch, hip flexor stretches, and squat). in additionn, The TENS electrodes are typically placed bilaterally along the lumbar paraspinal region directly over the painful area. The frequency of the output was set at 4 to 8 Hz. Continuous type used.
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
opaque sealed envelope
Intervention model description
mobilization and conventional treatment
Eligibility
Sex/Gender
FEMALE
Age
40 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* Chronic female Patients diagnosed as grade 1 lumbar degenerative spondylolisthesis (anterolisthesis) referred from Orthopedists was confirmed by lumbosacral x-ray * Patients age ranged from 40 to 60 years. * BMI(25:35) * Ambulant patient with or without cane. * Cooperative patients with ability to understand instructions and follow simple verbal commands.
Exclusion criteria
* Osteoporosis. * Pregnancy. * Signs consistent with nerve root compression (reproduction of low-back or leg pain with a straight leg raise at less than 45°, muscle weakness involving a major muscle group of the lower extremity, diminished lower extremity muscle stretch reflex, or diminished or absent sensation to pinprick in any lower extremity dermatome). * General tumors, spinal tumor, fracture, cauda equina syndrome, and previous surgery. * Other causes of spondylolisthesis. * Patients with (BMI ≥ 35) * Severe or life-threatening psychiatric illness.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| low back disability | up to four weeks | Arabic version of Roland Morris Disability will be used to assess low back disability. it is a valid, reliable 24-item tool used to assess physical disability in patients with low back pain (LBP). It has been culturally adapted to Modern Standard Arabic, with a score ranging from 0 to 24, where higher scores indicate greater functional disability. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| pain intensity | up to four weeks | The visual analogie scale will be used to assess pain intensity. it is a one-dimensional instrument used to assess subjective pain intensity. It comprises a 10-cm (100-mm) line; with 0 refer to no pain while 100mm refer to extreme pain. |
| lumbar flexion range of motion | up to four weeks | The BROM device will be used for lumbar flexion ROM. |
Contacts
CONTACTAlaa Kazamel, master
Outcome results
None listed