Background Lumbar disc herniation (LDH), defined as the localized displacement of disc material beyond the margins of the intervertebral disc space, is considered to be the most common cause of lumbosacral radiculopathy. Despite being the preferred initial management method, the efficacy of many conservative treatments for LDH remains unclear.
Objectives This clinical trial aimed to verify the effectiveness of two therapies, lumbar segmental stabilization and transcutaneous electrical nerve stimulation (TENS), on pain, functional disability, and activation of the transversus abdominis muscle (TrA), in individuals with LDH.
Methods This study involved 23 patients randomized into two groups: Stabilization Group (SG n=12; age 43.58±7.17; BMI 26.47±3.39), which received exercises of lumbar segmental stabilization (transversus abdominis and lumbar multifidus muscles exercises), and TENS Group (TG n=11; age 46.45±5.14; BMI 26.92±3.02), who received electrotherapy. Both groups received 16 sessions, lasting 60 minutes, twice a week and were evaluated before and after 8 weeks. The following instruments were used: Visual Analog Pain Scale for pain, Oswestry disability questionnaire for functional disability and pressure biofeedback unit for the ability to contract the TrA muscle. Intragroup statistical analysis was performed using the t-test for data sets with normal distribution and the same variance and Wilcoxon Signed Rank Test for data sets without normal distribution or equal variance. The significance level was α=0.05.
Results After eight weeks, Stabilization Group showed statistically significant improvement in pain (6.16±1.26; 1.58±1.24; p<0.001), functional disability (15.50±3.77; 4.83±2.94; p<0,001) and the ability to contract the TrA muscle (-0.83±1.49;-3.16±0.77; p<0,001). There was no statistically significant difference in TENS Group for functional disability (18.09±4.27;17.09±7.96; p=0.569) and ability to contract the TrA muscle (-1.40±0.83; -1.54±0.93; p=0.557), howeverit wasdemonstratedimprovement in pain (6.90±2.30;4.81±2.52; p=0.004).
Conclusions The results indicate that the Lumbar Stabilization is effective in improving pain, functional disability and the ability to contract the TrA in individuals with lumbar disc herniation. However in theTENS grouponly pain improved after eight weeks of treatment.
Awad JN, Moskovich R. Lumbar disc herniation. Clin Orthop Relat Res 2006; 443: 183-97.
Barr KP, Griggs M, Cadby T. Lumbar stabilization: core concepts and current literature, part 1. Am J Phys Med Rehabil 2005 Jun; 84(6): 473-80.
Richardson C, Hodges P, Hides J. Therapeutic exercise for lumbopelvic stabilization. A motor control approach for the treatment and prevention of low back pain. 2nd ed. Churchill Livingstone, 2004.
Vigatto R, Alexandre NMC, Filho HRC. Development of a brazilian portuguese version of the oswestry disability index. Spine 2007; 32(4): 481-6.
Disclosure of Interest None Declared