Journal of the Korea Academia-Industrial cooperation Society (한국산학기술학회논문지)

The Korea Academia-Industrial cooperation Society (한국산학기술학회)
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The Effects of Spinal Decompression Combined with Therapeutic Modalities for Patients with Lumbar Radiculopathy

치료적 모달리티를 병용한 척추 감압치료가 요추 신경뿌리병증 환자에게 미치는 효과

  • Ma, Sang-Yeol (Dept. of Physical Therapy, Masan University) ;
  • Kwon, Won-An (Dept. of Physical Therapy, Daegu Health College) ;
  • Lee, Jae-Hong (Dept. of Physical Therapy, Daegu Health College) ;
  • Min, Dong-Gi (Dept. of Physical Therapy, Hyundae Union Clinic)
  • 마상렬 (마산대학교 물리치료과) ;
  • 권원안 (대구보건대학교 물리치료과) ;
  • 이재홍 (대구보건대학교 물리치료과) ;
  • 민동기 (현대연합의원 물리치료실)
  • Received : 2012.09.04
  • Accepted : 2013.01.10
  • Published : 2013.01.31
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Abstract

The purpose of the present study was to determine the effect of 4 weeks course of motorized spinal decompression delivered via SpineMT(mobilization & traction) combined with therapeutic modalities on the treatment of patients with lumbar radiculopathy(LRP). A total of 15 patients with LRP (mean age, 36.63 years; age range 20-50years) participated in this study. 4 weeks course of spinal decompression delivered via SpineMT combined with therapeutic modalities was delivered to the patients for 6 days per week for the first two weeks, and four times per week for two additional weeks. The entire treatment consisted of 20 visits over 4 week period. Comparisons of changes in the muscle strengthening (MS), straight leg raise (SLR), and Oswestry disability index (ODI) at pre-intervention, after 10 treatment sessions, and at discharge (after 20 treatment sessions) were analyzed. There were significant improvements in the outcome measures of MS test, SLR test, and ODI score after 10 and 20 sessions of spinal decompression treatment combined with therapeutic modalities as compared with the pre-intervention(p<0.05). Spinal decompression treatment combined with therapeutic modalities appears to be a safe and efficacious, noninvasive treatment modality for patients with LRP.

본 연구의 목적은 요추 추간판 탈출증 환자에게 치료적 모달리티와 SpineMT(mobilization & traction)를 이용한 척추 감압치료 효과를 확인하는 것이다. 요추 추간판 탈출증 환자 15명(나이 36.62, 범위 20-50, 남자 7명과 여자 8명)을 대상으로 4주간 적용하였다. 치료적 모달리티와 척추 감압치료를 첫 2주 동안 주 6일, 12회 적용하였으며, 마지막 2주간은 주 4일 8회 적용하였다. 모든 실험대상자에게 4주 동안 20회를 적용하였다. 측정은 오스웨스트리 요통장애지수, 근력, 하지 직거상 검사는 실험 전, 치료 10회 후, 치료 20회 후 변화의 차이를 일요인 반복측정을 이용하였으며, 추간판 탈출지수는 실험 전, 치료 20회 후 변화 차이를 대응표본 t-검정을 이용하여 측정하였다. 치료적 중재 기간에 따라 치료 전, 2주 후, 4주 후 측정결과 오스웨스트리 요통장애 지수, 하지 직거상 검사, 그리고 근력은 치료 10회 후, 치료 20회 후가 치료 전에 비하여 통계학적 유의한 변화가 있었다(p<0.05). 그러나 추간판 탈출 지수는 치료 전에 비하여 감소함을 나타냈으나 통계학적으로 유의한 변화는 없었다(p>0.05). 결론적으로 요추 추간판 탈출증 환자에게 치료적 모달리티와 척추 감압치료가 요통장애지수, 하지 직거상 검사, 근력 개선에 효과적이란 결론을 얻었다. 이것은 척추 감압치료의 안전성과 효과의 확인, 그리고 요추 추간판 탈출증 환자에게 비수술적 치료법으로서의 근거를 제시하였다.

Keywords

References

  1. Rubin, D. I. Epidemiology and risk factors for spine pain. Neurol Clin. 25, 353-371, 2007. http://dx.doi.org/10.1016/j.ncl.2007.01.004
  2. Katz, J. N. Lumbar disc disorders and low-back pain: socioeconomic factors and consequences. J. Bone Joint Surg. Am. 88, 21-24, 2006. DOI: http://dx.doi.org/10.2106/JBJS.E.01273
  3. Frymoyer, J. W. and Cats-Baril, W. L. An overview of the incidences and costs of low back pain. Orthop. Clin. North. Am, 22, 263-271, 1991.
  4. Goh, K. J., Khalifa, W., Anslow, P., Cadoux, H. T., and Donaghy, M. The clinical syndrome associated with lumbar spinal stenosis. Eur. Neurol. 52, 242-249, 2004. DOI: http://dx.doi.org/10.1159/000082369
  5. Gay, R. E., Bronfort, G., and Evans, R. L. Distraction manipulation of the lumbar spine : A review of the literature. J. Manipulative Phys. Ther. 28, 266-73, 2005. DOI: http://dx.doi.org/10.1016/j.jmpt.2005.03.012
  6. Ma, S. Y. Effect of whole body cryotherapy with spinal decompression on lumbar disc herniation by functional assessment measures. J. Korean data & information Sci. Soc. 21(1), 1101-1108, 2010.
  7. Ma, S. Y. and Kim, H. D. The efficacy of spinal decompression via DRX3000 combined with a spinal mobilization and a lumbar stabilization exercise program for patients with discogenic low back pain. J. Phys. Ther. Sci. 22, 345-354, 2010. DOI: http://dx.doi.org/10.1589/jpts.22.345
  8. Gionis, T. A. and Groteke, E. Spinal Decompression. Orthopedic Technology Rev. 5, 36-39, 2003.
  9. Kim, H. S., Yoon, D. H., and Heo, K. E. Effect of Spinal Decompression Therapy. Compared with Intermittent Mechanical Traction in Lumbosacral Disc Herniation. J. Korea acad. Rehab. Med. 32, 319-323, 2008.
  10. Macario, A., Richmond, C., Auster, M., and Perglizzi, J. V. Treatment of 94 outpatients with chronic discogenic low back pain with the DRX9000: a retrospective chart review. Pain Pract. 8, 11-17, 2008. DOI: http://dx.doi.org/10.1111/j.1533-2500.2007.00167.x
  11. Waddell, G., Somerville, D., Henderson, I., and Newton, M. Objective clinical evaluation of physical impairment in chronic low back pain. Spine. 17, 617-628, 1992. DOI: http://dx.doi.org/10.1097/00007632-199206000-00001
  12. Fagerlund, M. K., Thelander, U., and Friberg, S. Size of lumbar disc hernias measured using computed tomography and related to sciatic symptoms. Acta. Radiol. 31, 555-8, 1990. DOI: http://dx.doi.org/10.3109/02841859009173096
  13. Nakagawa, H., Kamimura, M., Takahara, K., Hashidate, H., Kawaguchi, A., Uchiyama, S., and Miyasaka, T. Optimal duration of conservative treatment for lumbar disc herniation depending on the type of herniation. J. Clin. Neuro. 14, 104-109, 2007. DOI: http://dx.doi.org/10.1016/j.jocn.2006.08.001
  14. Thomas, K. C., Fisher, C. G., Boyd, M., Bishop, P., Wing, P., and Dvorak, M. F. Outcome evaluation of surgical and nonsurgical management of lumbar disc protrusion causing radiculopathy. Spine, 32, 1414-1422, 2007. DOI: http://dx.doi.org/10.1097/BRS.0b013e318060a5d1
  15. Gunzburg, R., Parkinson, R., Moore, R., Candtraine, F., Hutton, W., Vernon-Roberts, B., and Frasor, R. A cadaveric study comparing discography, magnetic resonance imaging, histology and mechanical behavior of the human lumbar disc. Spine, 17, 417-426. 1992. DOI: http://dx.doi.org/10.1097/00007632-199204000-00007
  16. Guehring, T., Omlor, G. W., Lorenz, H., Enge lleiter, K., Richter, W., Carstens, C., and Kroeber, M. Disc distraction shows evidence of regenerative potential in degenerated intervertebral discs as evaluated by protein expression, magnetic resonance imaging, and messenger ribonucleic acid expression analysis. Spine, 31, 1658-1665, 2006. DOI: http://dx.doi.org/10.1097/01.brs.0000224558.81765.56
  17. Sari, H., Akarirmak, U., Karacan, I., and Akman, H. Computed tomographic evaluation of lumbar spinal structures during traction. Phys. Theory Pract. 21, 3-11, 2005. DOI: http://dx.doi.org/10.1080/09593980590911507
  18. Boden, S. D., Davis, D. O., Dina, T. S., Patronas, N. J., and Wiesel, S. W. Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. a perspective investigation. J. Bone Joint Surg. Am. 72, 403-408, 1990. https://doi.org/10.2106/00004623-199072030-00013
  19. Wilberger, J. E., and Pang, D. Syndrome of the incidental herniated lumbar disc. J. Neurosurg. 59, 137-41, 1983. DOI: http://dx.doi.org/10.3171/jns.1983.59.1.0137
  20. Boos, N., Rieder, R., Schade, V., Spratt, K. F., Semmer, N., and Aebi, M. 1995. The diagnostic accuracy of magnetic resonance imaging, work perception, and psychosocial factors in identifying symptomatic disc herniations. Spine. 20, 2613-25. DOI: http://dx.doi.org/10.1097/00007632-199512150-00002
  21. Griffith, J. F., Wang, Y. X., Antonio, G. E., Choi, K. C., Yu, A., Ahuja, A. T., and Leung, P. C. Modified Pfirrmann grading system for lumbar intervertebral disc degeneration. spine. 32(24), E708-E712, 2007. https://doi.org/10.1097/BRS.0b013e31815a59a0
  22. Chatani, K., Kawakami, M., Weinstein, J. N., Meller, S. T., and Gebhart, G. F. Characterization of thermal hyperalgesia, c-fos expression, and alterations in neuropeptides after mechanical irritation of the dorsal root ganglion. Spine. 20, 277-289, 1995. DOI:http://dx.doi.org/10.1097/00007632-199502000-00004
  23. Howe, J. E., Loeser, J. D., and Calvin, W. H. Mechanosensitivity of dorsal root ganglia and chronically injured axons:A physiological basis for the radicular pain of nerve root compression. Pain. 3, 25-41, 1977. DOI: http://dx.doi.org/10.1016/0304-3959(77)90033-1