Clinical picture dynamics in lumboischiadic syndrome, with and without radicular irritation, using McKenzie concept principles
Abstract
Aim Comparison of intensity, sensitive and affective components, disability, motion range of the m. erector spinae muscle activity during both dynamic and static activities at the sagittal level regarding the most frequent diagnoses, within the framework of classification by the McKenzie method. Patient sample The research sample consisted of 31 patients by the MRI-diagnosed discopathy, who were divided into two groups.
Both of these groups were treated using the McKenzie method. Group 1 involved the central symmetrical posterior derangement (n = 15).
Group 2 involved the unilateral asymmetrical derangement, with emanation of pain into the lower limb (n = 16). Methods For the measurement of the intensity and character of pain, the McGill Pain Questionnaire - its short form (SF MPQ) was used.
The pain intensity was evaluated by the visual analogue scale (VAS). The disability was evaluated by the Roland Morris Questionnaire (RMQ).
The m. erector spinae muscle activation measurement from L4 area paravertebrally was conducted by the surface EMG in μV. The range of motion was measured by a goniometry.
Results Group 1: activation of the m. erector spinae: no significant lateral differences were found and activation of the m. erector spinae was declining symmetrically. Group 2: in this group, there was the occurrence of lateral differences recorded on the right side versus the left side.
On the painful side, the activation changes manifested themselves most markedly with their increase during the flexion in the upright posture and with their decline occurring during extension while standing, which presented the therapeutic principle. In the assessment of intensity and perception of pain, disability and motion ranges, no significant differences were found.
One month and three months after the treatment there was a significant decrease in pain in both of the groups (p < 0.05). Conclusion During the treatment, we have managed to record changes in intensity, pain localization and motion ranges in the monitored groups, which was in compliance with the clinical picture syndromes according to McKenzie. (C) 2015 Faculty of Health and Social Studies of University of South Bohemia in České Budějovice.