Effect of manipultaive physical therapy on nerve root functions in discogenic lumbosacral radiculopathy patients / Mohamed Badr Mohamed Hassanein ; Supervised Eman Samir Mohamed Fayez , Khaled Ahmed Fawaz , Mohamed Abdelhakeim Kasem

Thesis (M.Sc.) - Cairo University - Physical Therapy - Department of Physical Therapy for Neuromuscular and NeuroSurgery

Background: Lumbosacral radiculopathy (LSR) is a common clinical problem that involves L5 and S1 nerve roots and often results in persistent disability. The use of spinal manipulative therapy (SMT) for patients with symptomatic lumbar disc disease has been suggested for the management of lumbosacral radiculopathy. Purpose: to investigate the effect of manipulative physical therapy on pain and nerve root function. Methods: Fourteen discogenic lumbosacral radiculopathy patients from both sexes participated in this study. They randomly assigned into 2 equal groups. Group A (Experimental): every patient received 3 sessions per week for 4 weeks consisted of 20 minute side posture positioning, rotatory mobilization and rotatory manipulation of lumbar spine, neurodynamic mobilization, and core stability. Group B (control): received program as Group A without neurodynamic mobilization. All patients assessed for back pain by Visual analogue scale (VAS), Disability by Oswestry disability index, and for soleus H-reflex amplitude (symptomatic, asymptomatic sides, and ratio between) by surface EMG unit, and fractional anisotropy, mean diffusivity (MD) & Apparent diffusion coefficient (ADC) (symptomatic & asymptomatic sides) by MRI. Results: There was significant improvement post treatment within both groups for all dependent variables in the symptomatic side except MD & ADC, but none in the asymptomatic side. Independent t-test revealed non-significant differences in any dependent variable (but ADC symptomatic post-score was more similar to asymptomatic pre-score in group A, than group B, that had a trend toward significance, P-value=0.1)

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