Department of Physiotherapy, Federal Medical Center, Nguru, Yobe State, Nigeria.
Department of Physiotherapy, Faculty of Allied Health Sciences, College of Health Sciences, Bayero University, Kano, Nigeria.
J Osteopath Med. 2021 Feb 26;121(4):391-400. doi: 10.1515/jom-2020-0261.
Evidence has shown that spinal mobilization with leg movement (SMWLM) and progressive inhibition of neuromuscular structures (PINS) are individually effective in the management of lumbar radiculopathy. However, previous evidence reported data for only a short-term study period and did not investigate the effect of the combined manual therapy techniques.
To compare the combined effects of two manual therapy techniques (SMWLM and PINS) with the individual techniques alone (SMWLM or PINS) in the management of individuals with lumbar radiculopathy.
A total of 60 patients diagnosed with unilateral lumbar radiculopathy secondary to disc herniation were randomly allocated into three groups: 20 participants each in the SMWLM, PINS, and combined SMWLM + PINS groups. Each group attended two treatments per week for 30 min each, for three months. Participants were assessed at baseline, immediately posttreatment, and then at three, six, and nine months follow-up using the Visual Analog Scale (VAS), Rolland-Morris Disability Questionnaire (RMDQ), and Sciatica Bothersomeness Index (SBI).
Between-groups analyses using a two-way repeated-measures analysis of variance indicated significant interactions between groups and follow-up times for all outcomes (p=0.001). Participants receiving combined SMWLM + PINS treatment experienced greater improvement in leg pain, back pain, disability, and sciatica at all timelines (immediately posttreatment, and three, six, and nine months follow-up) than the participants receiving SMWLM or PINS alone (p<0.05). However, participants receiving SMWLM alone showed better improvement than the participants receiving PINS alone at all timelines (p<0.05).
A combined SMWLM + PINS treatment protocol showed greater improvement than the individual techniques alone in the management of individuals with LR in this study.
有证据表明，脊柱松动伴下肢运动（SMWLM）和渐进性神经肌肉结构抑制（PINS）在腰椎神经根病的治疗中单独应用均有效。然而，之前的证据仅报告了短期研究期间的数据，并未研究联合手法治疗技术的效果。
比较两种手法治疗技术（SMWLM 和 PINS）联合与单独应用（SMWLM 或 PINS）治疗腰椎神经根病患者的效果。
共有 60 名单侧腰椎间盘突出症继发神经根病患者被随机分为三组：SMWLM 组、PINS 组和联合 SMWLM+PINS 组，每组 20 名。每组每周接受 2 次治疗，每次 30 分钟，共 3 个月。患者在基线、治疗后即刻以及 3、6 和 9 个月随访时使用视觉模拟评分（VAS）、Roland-Morris 残疾问卷（RMDQ）和坐骨神经痛困扰指数（SBI）进行评估。
使用双向重复测量方差分析的组间分析表明，所有结局的组间和随访时间均存在显著交互作用（p=0.001）。接受联合 SMWLM+PINS 治疗的患者在所有时间点（治疗后即刻、3、6 和 9 个月随访）的腿痛、腰痛、残疾和坐骨神经痛均有更大的改善，优于仅接受 SMWLM 或 PINS 治疗的患者（p<0.05）。然而，仅接受 SMWLM 治疗的患者在所有时间点的改善均优于仅接受 PINS 治疗的患者（p<0.05）。
在本研究中，与单独应用技术相比，联合 SMWLM+PINS 治疗方案在治疗 LR 患者方面显示出更大的改善。
