Effectiveness of Kinetic Control versus Mckenzie Execises on Functional Outcomes in patients with lumbar radiculopathy – A single blinded randomized pilot study.
DOI:
https://doi.org/10.46858/VIMSJPT.6213Abstract
Background: The term lumbar radiculopathy (LR) is a condition caused by compression and/or irritation of lumbar nerve roots by intervertebral disk degeneration or herniation, degenerative arthritis, lumbar stenosis, and other conditions like bone or muscle tumors, infections, or inflammation.1,2 Physical therapy techniques to treat lumbar radiculopathy includes, Neural tissue mobilization exercises, Stabilization, Kinetic control exercises for lumbar spine, manipulation technique, Direction based Mckenzie exercises along with conventional physiotherapy. There is lack of literature on effectiveness of kinetic control and Mckenzie exercises in patients with Lumbar Radiculopathy. Hence this study is conducted to find out the which treatment will be more effective.
Methodology: Study was conducted among 8 individuals of age 25-45 years having Lumbar Radiculopathy who were divided into two groups. 4 individuals of group A received Motor Control Exercises and 4 of group B received Mckenzie Exercises. Pain, Range of Motion of Lumbar Spine, Strength of Trunk muscles and Back Disability were assessed pre-intervention and immediate post-intervention.
Result: A significant difference was found in both the groups for Pain (p=0.0319), Disability (p=0.018) & Flexion Range of motion of lumbar spine (p=0.002) except all other Range of motion & strength of trunk muscles (p=0.2070). When comparison done after 4 weeks the percentage of improvement in group A was much higher than group B.
Conclusion: Kinetic control exercises showed significant improvement in reducing pain, disability and improving lumbar spine flexion range of motion when compared to McKenzie while there is no any difference in extension, lateral flexion range of motion and strength of trunk muscles.
References
Tarulli AW, Raynor EM. Lumbosacral radiculopathy. Neurol Clin. 2007 May;25(2):387-405.
Coster S, De Bruijn SF, Tavy DL. Diagnostic value of history, physical examination and needle electromyography in diagnosing lumbosacral radiculopathy. J Neurol. 2010 Mar;257:332-7.
Van Boxem K, Cheng J, Patijn J, Van Kleef M, Lataster A, Mekhail N, et al. Lumbosacral radicular pain. In: Evidence?Based Interventional Pain Medicine: According to Clinical Diagnoses. 2011 Dec 2:71-86.
Bogduk N. On the definitions and physiology of back pain, referred pain, and radicular pain. Ból. 2010 Apr 7;11(1):37-.
Hussien HM, Abdel-Raoof NA, Kattabei OM, Ahmed HH. Effect of Mulligan concept lumbar SNAG on chronic nonspecific low back pain. J Chiropr Med. 2017 Jun;16(2):94-102.
Comerford M, Mottram S. Kinetic Control management of uncontrolled movements. 1st ed. Champaign (IL): Human Kinetics; 2012.
Niederer D, Engel T, Vogt L, Arampatzis A, Banzer W, Beck H, et al. Motor control stabilisation exercise for patients with non-specific low back pain: a prospective meta-analysis with multilevel meta-regressions on intervention effects. J Clin Med. 2020 Sep 22;9(9):3058.
de Carvalho ME, de Carvalho RM, Marques AP, de Carvalho Lucio LM, de Oliveira AC, Neto OP, et al. Low intensity laser and LED therapies associated with lateral decubitus position and flexion exercises of the lower limbs in patients with lumbar disk herniation: clinical randomized trial. Lasers Med Sci. 2016 Sep;31:1455-63.
Liebenson C, editor. Rehabilitation of the spine: a practitioner's manual. Philadelphia: Lippincott Williams & Wilkins; 2007.
Tang S, Mo Z, Zhang R. Acupuncture for lumbar disc herniation: a systematic review and meta-analysis. Acupunct Med. 2018 Apr;36(2):62-70.
Wenger HC, Cifu AS. Treatment of low back pain. JAMA. 2017 Aug 22;318(8):743-4.
Bernal-Utrera C, Gonzalez-Gerez JJ, Anarte-Lazo E, Rodriguez-Blanco C. Manual therapy versus therapeutic exercise in non-specific chronic neck pain: a randomized controlled trial. Trials. 2020 Dec;21(1):1-0.
Hodges PW, Moseley GL. Pain and motor control of the lumbopelvic region: effect and possible mechanisms. J Electromyogr Kinesiol. 2003 Aug;13(4):361-70.
Howard A, Knudsen PT. Advance expertise in use of real-time ultrasound imaging of motor control assessment and exercise prescription, certified provider of ASTYM treatment. 2009.
Shumway-Cook A, Woollacott MH. Motor control: translating research into clinical practice. Philadelphia: Lippincott Williams & Wilkins; 2007.
Miranda IF, Souza C, Schneider AT, Chagas LC, Loss JF. Comparison of low back mobility and stability exercises from Pilates in non-specific low back pain: a study protocol of a randomized controlled trial. Complement Ther Clin Pract. 2018 May;31:360-8.
Abo Alfa M, Elsayed E, Shendy W, Elawady M, Elkafrawy N. Kinetic Control versus Mulligan Mobilization effect on functional outcomes in patients with lumbar radiculopathy: randomized comparative study. Egypt J Chem. 2021 Oct;64(10):5597-606.
Maher C, Underwood M, Buchbinder R. Non-specific low back pain. Lancet. 2017 Feb 18;389(10070):736-47.
Jensen MP, Chen C, Brugger AM. Interpretation of visual analog scale ratings and change scores: a reanalysis of two clinical trials of postoperative pain. J Pain. 2003 Sep;4(7):407-14.
Ahmed G, Ramzy GM, Abdelaziz NG, Mahmoud MM, Essa MM, Lobbos BS, et al. Effect of kinetic control retraining on chronic low back pain with radiculopathy: a randomized controlled trial study. Int J Appl Exerc Physiol. 2020;9(12):188-95.
Liang C, Sun J, Cui X, Jiang Z, Zhang W, Li T. Spinal sagittal imbalance in patients with lumbar disc herniation: its spinopelvic characteristics, strength changes of the spinal musculature and natural history after lumbar discectomy. BMC Musculoskelet Disord. 2016 Dec;17:1-8.
Furlan AD, Clarke J, Esmail R, Sinclair S, Irvin E, Bombardier C. A critical review of reviews on the treatment of chronic low back pain. Spine. 2001 Apr 1;26(7):E155-62.
Simon CB, Riley III JL, Fillingim RB, Bishop MD, George SZ. Age group comparisons of TENS response among individuals with chronic axial low back pain. J Pain. 2015 Dec;16(12):1268-79.
Poon TH, Carus C. The effectiveness of laser therapy on the management of chronic low back pain. Int J Ther Rehabil. 2016 Sep 2;23(9):432-43.
Shamsi M, Sarrafzadeh J, Jamshidi A, Arjmand N, Ghezelbash F. Comparison of spinal stability following motor control and general exercises in nonspecific chronic low back pain patients. Clin Biomech. 2017 Oct;48:42-8.
Petersen T, Larsen K, Jacobsen S. One-year follow-up comparison of the effectiveness of McKenzie treatment and strengthening training for patients with chronic low back pain: outcome and prognostic factors.
Danneels LA, Cools AM, Vanderstraeten GG, Cambier DC, Witvrouw EE, Bourgois J, et al. The effects of three different training modalities on the cross-sectional area of the paravertebral muscles. Scand J Med Sci Sports. 2001 Dec;11(6):335-41.
Enoka RM. Neural adaptations with chronic physical activity. J Biomech. 1997 May;30(5):447-55.
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