Mohani Mahek R, Arya Neha, Ratnani Grisha, Harjpal Pallavi, Phansopkar Pratik
Neurophysiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Neurophysiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institue of Higher Education and Research, Wardha, IND.
Cureus. 2024 Jan 14;16(1):e52275. doi: 10.7759/cureus.52275. eCollection 2024 Jan.
One of the most prevalent degenerative musculoskeletal conditions is lumbar spinal canal stenosis (LSS), which is characterized by narrowing of the lumbar spinal canal that pressures the nerve roots and cauda equine. LSS, when treated surgically, usually presents with foot drop as its major complication. Foot drop is a common presentation of several clinical diseases, traditionally characterized as severe weakening of ankle and toe dorsiflexion. Foot drop has a great impact on patients' lives, lowering their quality of life and affecting their activities of daily living. Ankle dorsiflexion weakness leads to foot drop and a high-stepping gait, which can cause multiple falls and accidents. This case study aimed to assess the efficacy of a customized physiotherapy program in a 50-year-old woman with paraparesis along with left foot drop and post-surgery complications following lumbar decompression and spinal fusion at L3-S1 (lumbar-sacral) level after a jerk experienced by her while working out in the gym. The objective was to determine the impact of individualized exercises on the patient's strength, gait, balance, and pelvic floor function over a 12-week rehabilitation period. The interventions included lower limb exercises (stretching exercises, strengthening exercises, and weight-bearing exercises), pelvic floor exercises, and core stability training. The findings demonstrated significant improvements in the patient's functional outcomes, as evidenced by enhanced scores in the Berg Balance Scale, Manual Muscle Testing, Dynamic Gait Index, Barthel Index, and Stanmore Assessment Questionnaire. Notable progress was observed in the strength, balance, gait, and pelvic floor function, highlighting the positive influence of targeted physiotherapeutic interventions. This case underscores the importance of tailored exercise plans in addressing the complexities of post-surgery challenges, emphasizing the potential for comprehensive recovery and improved overall quality of life through personalized physiotherapy.
最常见的退行性肌肉骨骼疾病之一是腰椎管狭窄症（LSS），其特征是腰椎管狭窄，压迫神经根和马尾神经。LSS手术治疗后通常会出现足下垂这一主要并发症。足下垂是几种临床疾病的常见表现，传统上表现为踝关节和足趾背屈严重减弱。足下垂对患者生活有很大影响，降低其生活质量并影响日常生活活动。踝关节背屈无力会导致足下垂和高抬腿步态，可能引发多次跌倒和事故。本病例研究旨在评估定制物理治疗方案对一名50岁女性的疗效，该女性患有轻度截瘫并伴有左脚下垂，以及在健身房锻炼时突然受伤后L3 - S1（腰骶部）水平进行腰椎减压和脊柱融合手术后的并发症。目的是确定在为期12周的康复期内，个性化运动对患者的力量、步态、平衡和盆底功能的影响。干预措施包括下肢运动（伸展运动、强化运动和负重运动）、盆底运动和核心稳定性训练。研究结果表明患者的功能结局有显著改善，伯格平衡量表、徒手肌力测试、动态步态指数、巴氏指数和斯坦莫尔评估问卷得分提高证明了这一点。在力量、平衡、步态和盆底功能方面观察到显著进展，突出了针对性物理治疗干预的积极影响。本病例强调了定制运动计划在应对手术后复杂挑战方面的重要性，强调了通过个性化物理治疗实现全面康复和提高整体生活质量的潜力。
