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孟加拉国达卡市腰椎间盘突出症患者住院物理治疗设置的多学科保守治疗结果:一项回顾性横断面研究

Multidisciplinary Conservative Treatment Outcomes of in-Patient Physiotherapy Set-Up Among Patients with Lumbar Disc Herniation in Dhaka City, Bangladesh: A Retrospective, Cross-Sectional Study.

作者信息

Hossain Md Shahadat, Akter Sapia, Siddique Mustafa Amimul Ehsan, Siddique Md Kaoser Bin, Reza G M, Alom Foisal Mohammad Mosiul, Ali Mohammad, Noman Md Obayadur Rahman, Rahman M Mazibar, Islam Md Shofiqul, Hossain K M Amran

机构信息

Bangladesh Institute of Manual Therapy & Research, Dhaka, Bangladesh.

Department of Statistics, Jahangirnagar University, Dhaka, Bangladesh.

出版信息

J Multidiscip Healthc. 2023 Mar 1;16:587-601. doi: 10.2147/JMDH.S400021. eCollection 2023.

Abstract

BACKGROUND

The study aimed to determine the outcome of Multidisciplinary physiotherapist-led conservative treatment of lumbar disc herniation at an in-patient set-up of a specialized spine center in Dhaka, Bangladesh.

METHODS

This was a retrospective cross-sectional study of 228 cases completing treatment and follow-up sessions. The outcome was evaluated as pain at rest and five different functional positions, neurological recovery, and Magnetic resonance imaging (MRI) changes during discharge and follow-up.

RESULTS

80.3% had a complete recovery with a typical motor and sensory status, no limitations in straight leg raise (SLR), no cauda equina symptom (CES), and no or <3 pain during more than 30 minutes of daily living activities. Statistically significant changes were noted at all outcome measures at the follow-up (day 90), compared to baseline (day 1) P<0.01. In the posthoc tests, pain, SLR, and CES had the most significant improvement at discharge (day 12) compared to the baseline (P < 0.01) and at follow-up compared to discharge (P < 0.01). No major adverse events noted.

CONCLUSION

Physiotherapist-led in-patient treatment results in significant resting and functional pain outcomes in 12 days. Also, the improvements in neurological recovery and normalizing disc position are statistically significant in 90 days.

摘要

背景

本研究旨在确定在孟加拉国达卡一家专业脊柱中心的住院部,由多学科物理治疗师主导的腰椎间盘突出症保守治疗的效果。

方法

这是一项对228例完成治疗和随访的病例进行的回顾性横断面研究。评估的结果包括静息时以及五个不同功能位置的疼痛、神经功能恢复情况,以及出院时和随访期间的磁共振成像(MRI)变化。

结果

80.3%的患者完全康复,具有典型的运动和感觉状态,直腿抬高(SLR)无受限,无马尾神经症状(CES),并且在超过30分钟的日常生活活动中无疼痛或疼痛程度<3。与基线(第1天)相比,随访(第90天)时所有结果指标均有统计学显著变化(P<0.01)。在事后检验中,与基线相比,出院时(第12天)疼痛、SLR和CES有最显著改善(P<0.01),与出院相比,随访时也有最显著改善(P<0.01)。未发现重大不良事件。

结论

由物理治疗师主导的住院治疗在12天内可产生显著的静息和功能性疼痛改善效果。此外,神经功能恢复和椎间盘位置正常化在90天内的改善具有统计学显著性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/130e/9985877/29b7f6c8de2b/JMDH-16-587-g0001.jpg

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