Borodulina I V, Badalov N G, Mukhina A A, Chesnikova E I, Yakovlev M Yu
Russian Medical Academy for Continuous Professional Education, Moscow, Russia.
Shvetsova Scientific and Practical Center for Medical and Social Rehabilitation, Moscow, Russia.
Vopr Kurortol Fizioter Lech Fiz Kult. 2022;99(2):45-52. doi: 10.17116/kurort20229902145.
Underwater traction of the spine is a physiotherapeutic method that combines the effects of mechanical traction and fresh water of indifferent temperature and seems promising for the treatment of pain in the lower back, which is due to the physiological basis of the mechanism of action on the spinal motion segment by eliminating muscle spasm and restoring the biomechanics of the spine.
To study the effectiveness of underwater horizontal traction in combination with mechanotherapy in patients with non-stenosing unstable degenerative spondylolisthesis of the lumbosacral spine of the 1st degree, accompanied by pain.
The clinical study included 14 patients (mean age 50.21 years). Patients underwent underwater horizontal traction of the spine according to the modified Pushkareva-Vozdvizhenskaya method in a variable mode, the procedures were performed every other day, for a course of 6 procedures. After completion of the traction procedure, patients were recommended to put on a fixing lumbosacral corset, in which they rested for 30 minutes in the supine position. At the end of the rest period, the patients performed training of the back muscles with biofeedback on the mechanotherapeutic complex of simulators for 30 minutes daily, except for weekends, for a course of 10 procedures.
All patients completed the course of treatment, during the procedures no side effects or deterioration were noted. During the treatment, motor and daily activity significantly improved according to the Oswestry scale (=0.002), the severity of the pain syndrome and its effect on the patient's activity decreased, according to the Roland-Morris questionnaire (=0.003). According to an objective assessment of the muscle strength of the lumbosacral spine at the initial level, no deviations from the normative parameters were revealed, however, during the treatment, a significant increase in strength was noted in all muscle groups.
Underwater horizontal traction of the spine in variable mode according to Pushkareva-Vozdvizhenskaya is an effective and safe method of conservative treatment of unstable non-stenosing degenerative spondylolisthesis of the 1st degree, accompanied by back pain, which helps to reduce the intensity of the pain syndrome and improve the daily motor and social activity of patients. The traction method should be supplemented with therapeutic exercises using mechanotherapeutic simulators to achieve a clinical result.
脊柱水下牵引是一种物理治疗方法,它结合了机械牵引和常温淡水的作用,对于治疗下背部疼痛似乎很有前景,这是由于其对脊柱运动节段的作用机制有生理基础,可消除肌肉痉挛并恢复脊柱生物力学。
研究水下水平牵引联合机械疗法对伴有疼痛的Ⅰ度腰骶部非狭窄性不稳定退行性椎体滑脱患者的有效性。
临床研究纳入14例患者(平均年龄50.21岁)。患者按照改良的普什卡列娃 - 沃兹德维任斯卡娅方法在可变模式下进行脊柱水下水平牵引,每隔一天进行一次操作,共进行6次疗程。牵引操作完成后,建议患者佩戴固定腰骶部的束腹带,在仰卧位休息30分钟。休息期结束后,患者除周末外每天在机械治疗模拟器的生物反馈下进行30分钟的背部肌肉训练,共进行10次疗程。
所有患者均完成治疗疗程,治疗过程中未观察到副作用或病情恶化。治疗期间,根据奥斯威斯利量表,运动和日常活动显著改善(P = 0.002),根据罗兰 - 莫里斯问卷,疼痛综合征的严重程度及其对患者活动的影响降低(P = 0.003)。根据对腰骶部脊柱肌肉力量的初始水平客观评估,未发现与正常参数的偏差,然而,在治疗期间,所有肌肉群的力量均显著增加。
按照普什卡列娃 - 沃兹德维任斯卡娅方法在可变模式下进行脊柱水下水平牵引是治疗伴有背痛的Ⅰ度不稳定非狭窄性退行性椎体滑脱的一种有效且安全的保守治疗方法,有助于减轻疼痛综合征的强度并改善患者的日常运动和社交活动。牵引方法应辅以使用机械治疗模拟器的治疗性锻炼以取得临床效果。