The current study aims to determine the impact of augmented posterior oblique sling activation on lumbopelvic recruitment pattern and functional outcomes in patients with unilateral lumbosacral radiculopathy.
Low back pain is now the leading cause of disability worldwide. Back pain and its related disability have a huge impact on individuals, communities, and healthcare systems. It reduces an individual's ability to participate in work which in turn negatively affects their quality of life. Also, it has major economic consequences through increasing the cost of health care and work absenteeism. Among the many differentials of low back pain, the most common cause is lumbosacral radiculopathy. Patients with low back pain showed uncontrolled lumbopelvic mobility while performing hip extension movement in functional activities. In patients with back pain, there is over-activation of the hamstrings and erector spinae and delayed or absent contraction of the gluteus maximus. Clinically, this pattern is observed as an anterior pelvic tilt with increased extension in the lumbar spine as the patient lifts the leg into extension. So, repetition of this abnormal pattern in patients with lumbosacral radiculopathy may result in mechanical and compressive stresses in the lumbar spine and magnify the patient's symptoms. Despite the role of POSM in improving spinal mobility and stability. And stabilizing the lumbopelvic joint, there are no previous studies investigating the impact of activation posterior oblique activation on this abnormal lumbopelvic recruitment and functional outcomes in patients with lumbosacral radiculopathy.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
40
activation of posterior oblique sling for 18 sessions, three sessions per week for six weeks
selected physical therapy program for 18 sessions, three sessions per week for six weeks in form hot packs, soft tissue techniques, mobilization and manipulation of lumbar spine, and neurodynamics and stabilization exercises
faculty of physical therapy Cairo university
Giza, Egypt
surface EMG unit
The electromyographic pattern of activation of lumbopelvic musculature (sequence and level of activity) will be measured during prone hip extension testing using surface EMG unit.
Time frame: measurements will be done 3 days before the start of the treatment program and will be done after 3 days post intervention
Pressure biofeedback unit
it will be used to assess pelvic motion. the pressure sensor of the pressure biofeedback unit will be placed anteriorly between the patients' ilium and the testing table. The amount of pressure applied by the patient on the sensor at rest will be recorded then, the amount of pressure applied by patients at prone hip extension at 10 degrees will be recorded.
Time frame: measurements will be done 3 days before the start of the treatment program and will be done after 3 days post intervention
pressure algometry
The pressure algometry will used to measure pressure pain threshold in low back area and in sciatic valleix.
Time frame: measurements will be done 3 days before the start of the treatment program and will be done after 3 days post intervention
Arabic version of Oswestry Low Back Pain Disability Questionnaire
back pain-related disability will be assessed using using the Arabic version of Oswestry Low Back Pain Disability Questionnaire.It is a 10-item self-reported questionnaire. The patient will be asked to answer every question and mark only the box that most closely describes his problem. Each question will be assessed on a six-point scale ranging from 0 (no disability) to 5 (major disability). The score is determined by adding each item score together. The overall score is out of 50 . Higher scores represent greater disability.
Time frame: measurements will be done 3 days before the start of the treatment program and will be done after 3 days post intervention
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back pain intensity using the Visual analogue scale
The subject will be asked to make a handwritten mark on a 100 mm line (10cm). This line represents a continuum between no pain or discomfort (zero), and the worst pain (10) the patient could feel. Measurements from the starting point of the scale to the patients' marks will be recorded and interpreted as their pain intensity. Higher scores represent greater pain.
Time frame: measurements will be done 3 days before the start of the treatment program and will be done after 3 days post intervention