Elena Jablonskytė
Abstract
The purpose of the research. The comparison of the osteophatic manipulative treatment (OMT) and the physiotherapy which was based on the sling exercise therapy for the patients experiencing low back pain. Study material and methods. The study was held from November 2014 until April 2015 at Vilnius University Hospital Santariskiu clinics, the Centre of the Rehabilitation, Physical and Sport Medicine, out-patient rehabilitation department. The patients were assessed before rehabilitation programme by applying documentary part, the Oswestry Disability Questionnaire and the Roland – Morris Questionare. The assessment of the pain characteristics and evaluation of the functional status of the vertebra was accomplished. The study sample comprised randomly recruited patients suffering from low back pain into two homogeneous groups that differ by applying accessory procedure: the experimental group underwent OMT, the control group – physiotherapy which was based on the sling exercise therapy. In all the treatment groups, procedures were performed by the same specialists and the same methods were used. The second evaluation was carried out on the same or next day after completion of the rehabilitation program. Statistical analysis was performed using SPPS 20.0 program and MS Excel. Results. The study included 43 patients, 30 (69.8%) women and 13 (30.2%) men. The average age was 44.4 ± 12.8 years, the youngest patient was 23 years old, the oldest – 68 years old. 93% of subjects consisted of the regularly employed. The distribution according to the phases of pain: acute phase – 9 (20.9%) subjects; subacute – 2 (4.7%), and acute exacerbations of chronic pain phase – 32 (74.4%) subjects. After rehabilitation, the pain intensity dropped from an average of 5.79 ± 1.92 to 3.37 ± 1.90 points of numerical pain scale (p <0.05). A statistically significant change of patients’ functional status was reflected by Roland – Morris questionnaire: the average before rehabilitation was 8.63 ± 6.65, after rehabilitation 4.79 ± 3.15 points (p <0.05). Before rehabilitation by Oswestry questionnaire analysis, the majority of patients – 53.5% was at moderate disability level. After applied rehabilitation programme the functional state of limitation for many dropped to the minimum disability – respectively, which accounted for 28 (65%) patients. A ststistically significant chanfe of patients‘ pain intensity and their functional status was found after comparing experimental and control groups after rehabilitation, indicators improved more in patients who had OMT (p < 0.05). Conclusions. 1. 93% of subjects consisted of regularly employed. 2. Applied rehabilitation programme significantly reduced pain intensity from an average of 5.79 ± 1.92 to 3.37 ± 1.90 points in numerical pain scale (p <0.05). 3. The statistically significant improvement of patients’ functional status was reflected by selfadministered disability measure standardized questionnaires: Oswestry Disability Index after rehabilitation program for many patients – 65% reduced to the minimum disability; Roland-Morris Disability estimate of average decreased from 8.63 ± 6.65 to 4.79 ± 3.15 points (p <0.05). 4. The significant difference between patients with spinal functional state before and after the rehabilitation programme was not found (p> 0.05). 5. Statistically significant reduction in pain and improvement in functional status was monitored in patients who underwent osteophatic manipulative treatment compared to patients who had additional physiotherapy which was based on the sling exercise therapy. 6. Osteopathy should be included in the rehabilitation process, because it is an effective treatment method. Lower back pain is the growing socio-economic problem. It is important to continue the rehabilitation performance assessment to include Osteopathy, as an effective method of treatment, creating optimal rehabilitation programme.
Keyword(s): low back pain; rehabilitation; osteoaphatic manipulative treatment; osteophatic procedure; Insight 7000 Subluxation Station.
DOI: 10.5200/sm-hs.2016.041
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