Aušrinė Urbonienė, Aleksandras Kriščiūnas, Raimondas Savickas


Objective was to evaluate the efficacy of outpatient rehabilitation and to determine factors that influence it in patients with disorders of the lumbosacral plexus. Methods. The research was performed in two stages. The outpatient rehabilitation medical records data of 280 patients with lumbosacral plexus disorders were analyzed retrospectively in the first stage. Rehabilitation efficacy was evaluated according to decrease in pain intensity. Prospective analysis of the outpatient rehabilitation efficacy was performed in the second stage. 39 patients with disorders of the lumbosacral plexus were examined using 0-10 Numeric Rating Scale, Roland Morris Disability Questionnaires (RMDQ) for low back and separate for leg (RMDQ-L) and the Brief ICF Core Set for Low Back Pain, at the start and the end of rehabilitation. Results. Retrospective study determined the average score of reduction in pain intensity was 2.7, (p<0.05). Pain decrease varied significantly in men and women groups. For patients with sensation disorders average reduction in pain intensity was less if compared to the patients without sensation disorders. Univariate logistic regression model was applied for the evaluation of sociodemographic factors, clinical data on the decrease of pain intensity. It was determined, that female gender (odds ratio -2.1 ( 95% CI 1.2-3.8, p=0.02), the absence of intervertebral disc herniation (odds ratio -2.5 ( 95% CI 1.0- 6.3, p=0.04), worst possible pain (9-10 points) (odds ratio -5.4; 95% CI 1.2-24.4, p=0.02) and severe pain (6-8 points) before rehabilitation (odds ratio -1.8; 95% CI 1.0-3.2, p=0.02) had the greatest importance in pain intensity decrease in 2 and more points. The prospective study determined the average score of reduction in low back pain intensity was 2.8, in leg pain – 2.5, disability level in RMDQ– 4.3, RMDQ-L– 3.7, (p<0.001). Reduction in low back pain was significantly related with return to work, (p<0.001), 60% of the researched employed people returned to work after rehabilitation. The status of patients evaluation according to ICF helped to identify the most significant problems and to determine patients environmental factors. Conclusion. Outpatient rehabilitation for patients with disorders of the lumbosacral plexus significantly reduces pain and disability. Reduction in pain was more in patients who complained about greater pain before rehabilitation. Male gender, diagnosed intervertebral disc herniation and sensation disorders are negative factors of rehabilitation efficacy. Patient state evaluation according to ICF helps to set the greatest problems of the patients not only according to the medical, but also according to the biopsychosocial approach.

Article in Lithuanian


Keyword(s): disorders of the lumbosacral plexus; outpatient rehabilitation; ICF
DOI: 10.5200/362
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