EFFECT OF THERAPEUTIC EXERCISES AND ACTIVITIES OF DAILY LIVING INSTRUCTIONS IN PROLAPSED LUMBAR INTERVERTEBRAL DISC

Md. Imam Shahriar*, Md. Mahfuzur Rahman, Mohammad Ilias, A. B. M. Zafar Sadeque, Fahad Islam

ABSTRACT

Background: Low back pain with or without sciatica is a major cause of morbidity throughout the world with the life time incidence of 50-70%. However clinically significant sciatica due to disc prolapse occurs in 4-6% of the population. Among various options for treatment of PLID Pharmacotherapy, thermotherapy & exercise therapy are commonly used/Therapeutic exercises and ADL instruction can enable greater return of neurological function and improves long term outcome and quality of life. Objective: The aim of study is to compare in this study an attempt has been made to see the effects of therapeutic exercises and ADL instruction in the treatment of prolapsed disc and their outcome. Methods: This prospective randomized clinical trial study was performed to find out the effect of therapeutic exercises and activity of daily (ADL) instructions in Patients with prolapsed lumbar intervertebral disc (PLID) in the department of Physical Medicine & Rehabilitation, Chittagong medical college hospital, over a period of six months. Study populations was all the patients of prolapsed lumbar intervertebral disc attending in the outpatient department of physical medicine & rehabilitation, during the study period. Evaluation was made at initial visit and follow up was done at third and sixth week by same investigator. In each visit measurement of pain intensity level was performed by using straight leg raising test, Visual Analogue scale (VAS) respectively. Post intervention result was compared with baseline result. Results: Among 70 participants 53(75.7%) were male and 17(24.3%) were female. The male: female ratio was 3.1:1. Mean age of patients were 43.81 years. Most of the patients were from poor in both groups which were 21 (60%) cases and 24 (68.6%) cases in group A and group B respectively. Only few patients were rich in both groups. pain was mild in 11.4% cases of group A and 17.1% cases of group B (p=0.587). LBP was intermittent in most of the cases in both groups which was 71.4% cases and 80.0% cases in group A and group B respectively. Pain aggravates in most of the patient by walking (28.6%) and bending (21.3%) in both groups. However significant difference between group A and group B was found at week 6 follow up (p=<.005). During the study the SLR was improved significantly on week 6 follow up. significant difference between group A and group B was found at week 6 follow up (p=<.005) regarding straight leg raising test (SLR) score. Conclusions: This study demonstrates the superiority of Therapeutic exercises and activities of daily living in reduction of pain in management of patients with prolapsed lumbar intervertebral disc.

Keywords: Therapeutic, prolapsed lumbar, thermotherapy, pharmacotherapy.